title: Association of Vitamin D With Stress Fractures: A Retrospective Cohort Study.
abstract: Vitamin D is an essential, fat-soluble nutrient that is a key modulator of bone health. Despite the gaining popularity throughout published medical studies, no consensus has been reached regarding a serum vitamin D level that will guarantee adequate skeletal health in a patient with an increased functional demand. The purpose of the present investigation was to examine the serum concentrations of vitamin D in patients with confirmed stress fractures. A total of 124 patients were included in our retrospective cohort study. Of the 124 patients, 53 had vitamin D levels measured within 3 months of diagnosis. An association was seen in patients with a stress fracture and vitamin D level measured, as 44 (83.02%) of the 53 patients had a serum 25-hydroxyvitamin D level <40 ng/mL. Although an association was seen at our institution in patients with stress fractures and a serum vitamin D concentration <40 ng/mL, a larger and prospective investigation is warranted to further understand the effect of vitamin D level and stress fracture prevention in an active, nonmilitary population.
authors.affiliation: Fellowship Director, Pennsylvania Intensive Lower Extremity Fellowship, Premier Orthopaedics and Sports Medicine, Malvern, PA.
authors.forename: Jason R
authors.initials: JR
authors.lastname: Miller
authors.affiliation: Fellow, Pennsylvania Intensive Lower Extremity Fellowship, Premier Orthopaedics and Sports Medicine, Malvern, PA. Electronic address: dr.karldunn@gmail.com.
authors.forename: Karl W
authors.initials: KW
authors.lastname: Dunn
authors.affiliation: Private Practice, Premier Orthopaedics and Sports Medicine, Malvern, PA.
authors.forename: Louis J
authors.initials: LJ
authors.lastname: Ciliberti
authors.affiliation: Resident, Phoenixville Hospital Podiatric Surgical Residency, Phoenixville, PA.
authors.forename: Rikhil D
authors.initials: RD
authors.lastname: Patel
authors.affiliation: Resident, Bryn Mawr Hospital Podiatric Surgical Residency, Bryn Mawr, PA.
authors.forename: Brock A
authors.initials: BA
authors.lastname: Swanson
mesh_terms: D000328:Adult; D015519:Bone Density / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D015775:Fractures, Stress / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008682:Metatarsal Bones / Q000293:injuries*; D012189:Retrospective Studies; D013997:Time Factors; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications*
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: bone health; deficiency; fatigue fracture; hypovitaminosis D; insufficiency; march fracture; supplementation