As a consequence of newly elevated standards for normal vitamin D levels, there is a renewed interest in vitamin D insufficiency and deficiency (<32 and <20 ng/ml, respectively) in the orthopedic patient population. This study tests the hypothesis that vitamin D insufficiency is comparably prevalent among both high- and low-energy fracture patients. A retrospective analysis of the medical records for 44 orthopedic trauma in-patients with non-vertebral fractures was conducted from June 1, 2006 to February 1, 2007. The obtained data included a 25-hydroxyvitamin D level, age, gender, and reason for admission; high-energy vs. low-energy fracture. Vitamin D insufficiency, 25(OH)D <32 ng/ml, was found in 59.1% of the patients. Significantly, more women (75%) than men (40%) were vitamin D insufficient among all fracture patients and specifically among high-energy fractures, 80% women insufficient vs. 25% men insufficient. In women, both high- and low-energy fractures present with vitamin D insufficiency (80% of high-energy fractures and 71.4% of low-energy fractures). In men, the mean vitamin D level was lower for low-energy fractures (16 ng/ml) compared to high-energy fractures (32 ng/ml). In addition, men with low-energy fractures were significantly older than men with high-energy fractures and women with low-energy fractures were also older. Statistically, more vitamin D insufficiency is seen in women and our results are consistent with the gender difference seen in the general population. Even among younger men who sustain a high-energy fracture, 25% are vitamin D insufficient. Women with fractures regardless of age or fracture energy level have low vitamin D levels. Levels of 25(OH)D should be measured in all orthopedic trauma patients and the American Society for Bone and Mineral Research and National Osteoporosis Foundation currently recommend that vitamin D levels should be corrected.
About the HSS Journal
HSS Journal, an academic peer-reviewed journal, is published twice a year, February and September, and features articles by internal faculty and HSS alumni that present current research and clinical work in the field of musculoskeletal medicine performed at HSS, including research articles, surgical procedures, and case reports.