Session VIII - General Interest

Sat., 10/12/13 Topics of General Interest, PAPER #95, 1:39 pm OTA 2013

Effectiveness of Vitamin D Therapy in Orthopaedic Trauma Patients

Brett D. Crist, MD; Daniel S. Robertson, MD; Tyler Jenkins, MD; Yvonne M. Murtha, MD; Gregory J. Della Rocca, MD, PhD; David A. Volgas, MD, James P. Stannard, MD;
University of Missouri; Columbia, Missouri, USA

Purpose: 77% of our orthopaedic trauma patients have been shown to have either vitamin D deficiency or insufficiency. The purpose of this study was to determine the effectiveness of our vitamin D treatment protocol in orthopaedic trauma patients. Our hypothesis was that vitamin D therapy normalized serum vitamin D levels.

Methods: A retrospective review was done of all orthopaedic trauma patients at a university Level I trauma center from January 1, 2009 to September 30, 2010. Patients were selected if they had an initial and repeat vitamin D-25 serum levels. The standard regimen for all patients was over-the-counter vitamin D 1000 IU and 1500 mg of calcium daily. For patients with vitamin D deficiency or insufficiency, they also received 50,000 IU of ergocalciferol weekly until their vitamin D level normalized or their fracture healed. No compliance monitoring was performed except for questioning at each clinic visit.

Results: 201 patients had initial and repeat Vitamin D-25 levels. 84% of patients with a normal initial vitamin D-25 level remained normal and 16% became insufficient or deficient. 48% of the patients initially in the insufficient group improved to normal and 8% became deficient. Of the patients with vitamin D deficiency, 26% remained deficient and 74% became insufficient (see table).

Conclusion: Although Vitamin D therapy did improve the majority of the patients’ vitamin D-25 level, it was not as successful as was hoped. Patients with initial deficiency had the largest improvement but still did not normalize. This study indicates that continued vigilance is required to adequately treat a low vitamin D-25 level. Future studies will prospectively evaluate treatment regimens and the effect of low vitamin D on complications of orthopaedic trauma.

Alphabetical Disclosure Listing

• The FDA has not cleared this drug and/or medical device for the use described in this presentation   (i.e., the drug or medical device is being discussed for an “off label” use).  ◆FDA information not available at time of printing. Δ OTA Grant.