title: Vitamin D Deficiency in Pediatric Fracture Patients: Prevalence, Risk Factors, and Vitamin D Supplementation.
abstract: Although vitamin D levels are not routinely monitored in pediatric fracture patients, identification of children with a vitamin D deficiency may be clinically relevant because of the potential role of vitamin D in fracture healing. This study aimed to determine the prevalence of vitamin D deficiency in a pediatric fracture population and to identify risk factors for deficiency.
  
  
  
  All pediatric patients (<18 years) who were treated for a fracture of the upper or lower extremity from September 2012 to October 2013 in the outpatient setting of a level one trauma center were included in this cross-sectional study. Vitamin D deficiency was defined as a serum calcidiol <50 nmol/L. Potential risk factors for vitamin D deficiency were analysed using multivariable logistic regression analysis.
  
  
  
  A total of 108 boys (58%) and 79 girls, of a mean age 11.1 years (standard deviation 3.9), who had undergone 189 fractures were included in the study. Sixty-four children (34%) were vitamin D deficient. Of those with follow-up measurements, 74% were no longer deficient after supplementation. Vitamin D status did not influence the occurrence of complications during fracture treatment. Independent risk factors for vitamin D deficiency were older age, season (spring), and a non-Caucasian skin type.
  
  
  
  Clinicians who treat children with a fracture should inform patients and parents on vitamin D supplementation. Vitamin D measurement and supplementation may be needed for children with a non-Caucasian skin type or for those who present with a fracture during spring months.
authors.affiliation: Leiden University Medical Center, Department of Surgery and Traumatology, Leiden, The Netherlands, Phone: +31 71 526 1065 E-mail: e.a.gorter@lumc.nl.
authors.forename: Erwin A
authors.initials: EA
authors.lastname: Gorter
authors.forename: Wilma
authors.initials: W
authors.lastname: Oostdijk
authors.forename: Abraham
authors.initials: A
authors.lastname: Felius
authors.forename: Pieta
authors.initials: P
authors.lastname: Krijnen
authors.forename: Inger B
authors.initials: IB
authors.lastname: Schipper
mesh_terms: D000293:Adolescent; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009426:Netherlands / Q000453:epidemiology; D010045:Outpatients / Q000706:statistics & numerical data*; D015995:Prevalence; D012307:Risk Factors; D014807:Vitamin D / Q000008:administration & dosage / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology
chemical_list: D050071:Bone Density Conservation Agents; D014807:Vitamin D