Prevalence of hypovitaminosis D among children with upper extremity fractures.

BACKGROUND: 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.

METHODS: 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.

RESULTS: 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.

CONCLUSIONS: 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.

LEVEL OF EVIDENCE: Retrospective chart review; Level III evidence.