High prevalence of vitamin D deficiency in 2-17 year olds presenting with acute fractures in southern Australia.
OBJECTIVE
To determine vitamin D deficiency risk and other lifestyle factors in children aged 2-17 years presenting with an acute fracture to Sunshine Hospital.


METHODS
A prospective observational study was undertaken using a convenience sample data collected from children aged 2-17 years of age presenting with an acute fracture. Recruitment was undertaken over a 3-month period from February to May 2014. Risk factors for vitamin D deficiency (skin pigmentation, hours spent outdoors, sunscreen use and obesity) were identified. Patients providing consent, had measurements of serum 25-hydroxyvitamin D (25-OHD). Vitamin D deficiency was defined as < 50 nmol/L.


RESULTS
Of the 163 patients recruited into this study, 134 (82%) had one or more risk factor(s) for vitamin D deficiency. Of these, 109 (81%) consented to 25-OHD testing, with a median of 53 nmol/l (range 14-110 nmol/l) obtained. A total of 57 (52% at risk, 35% of total participants) were found to be vitamin D deficient. 45 (80%) had mild deficiency (30-50 nmol/l) and 11 (20%) had moderate deficiency (12.5-29 nmol/l).


CONCLUSIONS
One third of all participants, and the majority participants who had one or more risk factor(s) for vitamin D deficiency, were vitamin D deficient. Based on our findings we recommend that vitamin D status be assessed in all children with risk factor of vitamin D deficiency living in urban environments at higher latitudes presenting with fractures. The effect of vitamin D status on fracture risk and fracture healing in children and teenagers is yet to be determined, as do the effects of vitamin D supplementation in vitamin D deficient paediatric patients presenting with acute fracture.
Goulburn Valley Health, Shepparton 3630, Australia.
Dae Hwan
DH
Kwon
Paediatric Emergency Department, Western Health Sunshine Hospital, St Albans, Australia; Department of Paediatrics, University of Melbourne, Parkville 3052, Australia.
David
D
Krieser
Orthopaedics Department, Western Health, Sunshine Hospital, St Albans 3021, Australia.
Chris
C
Harris
Orthopaedics Department, Western Health, Sunshine Hospital, St Albans 3021, Australia.
Abhay
A
Khot
Department of Medicine, Monash University, Clayton 3168, Australia.
Peter R
PR
Ebeling
Department of Paediatrics, University of Melbourne, Parkville 3052, Australia; Department of Paediatrics, Monash University, Clayton 3168, Australia; Paediatric Department, Western Health, Sunshine Hospital, St Albans 3021, Australia; Australian Institute for Musculoskeletal Science (AIMSS).
Christine P
CP
Rodda
Children; Fracture; Reduced sun exposure; Risk factors for vitamin D deficiency; Teenagers; Vitamin D deficiency