Foot News

Vitamin D and Fractures
September 25, 2013

A recent review in the Journal of the American Academy Of Orthopedic Surgeons by Dr. Chad Patton and his colleagues at the University of Utah recently reviewed the effect of vitamin D on orthopedic problems. Vitamin D is a key to healthy bones. It is obtained through diet and sunlight. Since the 1950s, bread, milk, and breakfast cereals have been fortified with vitamin D to prevent rickets. It helps you metabolize and control the concentration of calcium in the bones and blood. Deficiency of vitamin D has been linked to osteoporosis, weak bones, fracture, and failure of surgical fixation after orthopedic procedures, although a direct relationship between fractures and vitamin D supplementation has been difficult to conclusively establish. Despite the fact that many foods are fortified with Vitamin D, many people with fractures are Vitamin D deficient.

One study looked at endocrine abnormalities in people whose fractures had failed to unite. Many of these patients had endocrine abnormalities and 68% were found to be vitamin D deficient. In fact, many of the fractures healed with medical treatment alone (vitamin supplementation). Vitamin D deficiency has also been linked to poor results after total hip replacement. However, it has been pointed out that vitamin D levels may reflect health status in general.

The authors recommend screening for vitamin D deficiency in patients over the age of 50 with fragility fractures such as compression fractures of the spine, hip, and wrist. The laboratory examination recommended included 25 hydroxy-vitamin D, serum calcium levels, and PTH (parathyroid hormone)levels. If vitamin D deficiency is present, supplementation with 1000 to 4000 units of vitamin D with 1000 mg of calcium supplementation daily may be recommended..

Subtle nutritional abnormalities are increasingly being recognized as contributing factors in medical problems. Vitamin D deficiency should be considered in a patient with an unusual or poorly healing fracture or as a contributing problems in osteoporosis especially in people over the age of 50.

–Brett Fink, MD. Co-author of The Whole Foot Book: A Comprehensive Guide to Taking Care of your Feet