title: Vitamin D and tibiofemoral joint orientation angles in children.
abstract: Vitamin D is an important component in musculoskeletal development and function in children. The aim of our study was to investigate serum vitamin D levels and tibiofemoral joint orientation angles in children. We performed a retrospective review on a consecutive series of children presenting with lower limb complaints. The children underwent an assessment of serum vitamin D level and full-length standing lower limb anteroposterior radiographs, and were divided into normal and deficient vitamin D groups. Tibiofemoral angles (TFAs) [lateral distal femoral angle (LDFA); medial proximal tibial angle (MPTA)] were measured by three independent observers and compared between the groups. Correlation tests between serum vitamin D level and TFAs were also performed. Sixty (39 boys, 21 girls) children were reviewed. The mean serum vitamin D level for the entire group was 26.8 ng/ml and 75% of the children were deficient. The mean serum vitamin D levels in the normal (11 boys, four girls) and deficient (28 boys, 17 girls) groups were 46.7 ng/ml (range: 32-100) and 20.2 ng/ml (range: 4-29), respectively. The mean right and left LDFAs were significantly higher in the normal compared to the deficient vitamin D group (right LDFA: 98.7° vs. 92.2°, P=0.031; left LDFA: 99.1° vs. 92.6°, P=0.018). We also found a correlation between serum vitamin D level and LDFAs (right ρ=0.29, P=0.03; left ρ=0.30, P=0.02). We found no difference in the right and left MPTAs in the normal and deficient vitamin D groups. In addition, we could not find a correlation between serum vitamin D level and MPTAs. The majority of children were vitamin D deficient. Serum vitamin D level was associated with a change and correlation to the LDFAs compared to MPTAs. Further work is required to investigate the effect of vitamin D supplementation on TFAs in children.
authors.affiliation: Department of Surgery, Section of Orthopedics, Hamad General Hospital, Doha, Qatar.
authors.forename: Nedal
authors.initials: N
authors.lastname: Alkhatib
authors.forename: Fadi
authors.initials: F
authors.lastname: Bouri
authors.forename: Abdelsalam
authors.initials: A
authors.lastname: Hegazy
authors.forename: Talal
authors.initials: T
authors.lastname: Ibrahim
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005269:Femur / Q000503:physiopathology; D006801:Humans; D007223:Infant; D007719:Knee Joint / Q000473:pathology*; D017880:Limb Deformities, Congenital / Q000150:complications*; D035002:Lower Extremity / Q000503:physiopathology*; D008297:Male; D015588:Observer Variation; D010045:Outpatients; D012189:Retrospective Studies; D013977:Tibia / Q000503:physiopathology; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000150:complications*
chemical_list: D014807:Vitamin D