title: The incidence of vitamin D deficiency amongst patients with a femoral neck fracture: are current bone protection guidelines sufficient ?
abstract: Vitamin D is required for calcium homeostasis and bone metabolism. This prospective observational study examined the incidence of vitamin D deficiency amongst patients with a fracture of the femoral neck, and the correlation between pre-admission use of bone-protection medication and vitamin D levels. Vitamin D assays were available in 75 out of 151 patients admitted with a hip fracture in February-March 2012; the assays were performed within one week of admission and surgery. The incidence of suboptimal vitamin D levels was 90% (68/75), with severe deficiency (<15nmol/l) or deficiency (<30nmol/l) seen in 71% (53/75). Only 7 patients were on bone protection medication at the time of admission, and all of them had suboptimal vitamin D levels. This suggests that the prevention is practically inexistent or at best insufficient. According to the literature, vitamin D deficiency is also associated with falls and maybe with outcome of surgery. Current management strategies may not be sufficient to address vitamin D deficiency and are overlooking an important and potentially modifiable risk factor.
authors.affiliation: Dept of Trauma and Orthopaedic Surgery, Leicester Royal Infirmary, Leicester, UK. davidjbryson@hotmail.com
authors.forename: David J
authors.initials: DJ
authors.lastname: Bryson
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Nichols
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Ford
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Williams
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D019386:Alendronate / Q000008:administration & dosage; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005265:Femoral Neck Fractures / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D014808:Vitamin D Deficiency / Q000453:epidemiology* / Q000517:prevention & control*
chemical_list: D050071:Bone Density Conservation Agents; D019386:Alendronate