Prevalence of hypovitaminosis D among children with upper extremity fractures.

Abstract

Recent publications show a high rate of hypovitaminosis D among children in general as well as among children with fractures. 25-hydroxyvitamin D levels were analyzed from hospital records to determine the prevalence of hypovitaminosis D, with the goal of using that information in fracture management and nutritional counseling. We retrospectively reviewed the records of 213 children with upper extremity fractures that were treated during a 14-month period. For 181 of those patients, the 25-hydroxyvitamin D level was measured at the time of emergency department presentation or at the first clinic appointment within 2 weeks after the initial presentation. The following information was collected from the charts: fracture mechanism (high or low energy), age, sex, race, and body mass index. Vitamin D levels were categorized as normal (≥ 32 ng/mL), insufficient (20 to 32 ng/mL), or deficient (< 20 ng/mL). The levels were analyzed with respect to fracture pattern and race. Of the 181 patients, 24% had deficient vitamin D levels, 41% had insufficient levels, and 35% had normal levels. There was no significant correlation with vitamin D level and mechanism of injury. African American children were more likely to have insufficient or deficient levels of vitamin D. Hypovitaminosis D is common among children with upper extremity fractures. Further investigation is warranted on the use of the 25-hydroxyvitamin D level as a screening tool to predict risk of fracture and to design proper nutritional programs for children with fractures. Retrospective chart review; Level III evidence.