Characterization of vitamin D deficiency and use of a standardized supplementation protocol in orthopaedic trauma patients

• Published in: European journal of orthopaedic surgery & traumatology Vol. 33; no. 4; pp. 955 - 960
• Main Authors: Gudeman, Andrew S., Dine, Serena A., Walroth, Todd A., Boyd, Allison N., Zahn, Evan D., Jacobson, Joseph E., Mullis, Brian H.
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 01-05-2023; Springer Nature B.V
• Subjects: Cohort analysis; Diabetes; Dietary Supplements; Fractures; Fractures, Bone - epidemiology; Humans; Medicine; Medicine & Public Health; Nonsteroidal anti-inflammatory drugs; Original Article; Orthopedics; Patients; Pharmacy; Primary care; Retrospective Studies; Surgery; Surgical Orthopedics; Trauma; Traumatic Surgery; Vitamin D; Vitamin D Deficiency - epidemiology; Vitamin D Deficiency - therapy; Vitamin deficiency; Vitamins; Fracture; Nonunion; Replacement; Vitamin D; Trauma
• ISSN: 1432-1068; 1633-8065; 1432-1068
• DOI: 10.1007/s00590-022-03231-0

Purpose
The objectives of this study were to assess the incidence of vitamin D deficiency in orthopaedic trauma patients, evaluate the safety and efficacy of a vitamin D supplementation protocol, and investigate the utility of vitamin D supplementation in reducing nonunions.
Methods
Three hundred seventy patients with operative tibia and/or fibula fractures were retrospectively reviewed. Both overall and matched cohorts were analysed.
Results
Ninety-eight per cent (
n
 = 210) were found to have vitamin D insufficiency (serum 25(OH)D level < 30 ng/ml). There were no cases of vitamin D toxicity following vitamin D replacement. Median follow-up vitamin D level was 22.7 ng/mL. No statistical difference between union rates was found between either the two consecutive cohorts or matched cohorts.
Conclusion
This vitamin D replacement protocol was a safe treatment for hypovitaminosis D, but post hoc analysis shows there would need to be over 1200 matched patients to achieve adequate power.