Evidence-Backed Management of Bone Disorders and Fractures With Vitamin D

[cmsmasters_row][cmsmasters_column data_width=”1/1″][cmsmasters_heading shortcode_id=”jfholstmx” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]An Overview of Vitamin D in Skeletal Health[/cmsmasters_heading][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”v862w3ubdr”][cmsmasters_column data_width=”1/2″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”0yw3l3j4o8″][cmsmasters_heading shortcode_id=”ir4e34z5rg” type=”h3″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Biosynthesis of Vitamin D and Its Role in Various Organs[/cmsmasters_heading][cmsmasters_text shortcode_id=”sl8znc14ir” animation_delay=”0″]

Synthesis of vitamin D and its role in various organs

Kidney

In Bone

testine

Parathyroid

[/cmsmasters_text][/cmsmasters_column][cmsmasters_column data_width=”1/2″ data_shortcode_id=”y80k89o7ma”][cmsmasters_image shortcode_id=”yfpd53icwg” align=”none” animation_delay=”0″ classes=”cmsmasters_image_n”]17800|https://www.kanishkhospital.com/wp-content/uploads/2023/03/Biosynthesis-of-Vitamin-D-and-Its-Role-in-Various-Organs.jpg|full[/cmsmasters_image][/cmsmasters_column][/cmsmasters_row][cmsmasters_row][cmsmasters_column data_width=”1/1″][cmsmasters_text]

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”juvajvwfa4″][cmsmasters_column data_width=”1/2″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”7apk9ibr8″][cmsmasters_heading shortcode_id=”a4mbinz5ge” type=”h3″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Importance of Vitamin D in Calcium Homeostasis [/cmsmasters_heading][cmsmasters_text shortcode_id=”ao1y83nk7g” animation_delay=”0″]

1. Vitamin D mediates intestinal calcium absorption through
2. Cation exchange proteins: PMCA1b and NCX1¹
3. Calbindin 9k¹
4. TRPV6¹

Without adequate vitamin D, the body absorbs no more than 10% to 15% of dietary calcium.²

Thus, a diet containing both optimal vitamin D and calcium is important for proper mineralization of bones.2

[/cmsmasters_text][/cmsmasters_column][cmsmasters_column data_width=”1/2″ data_shortcode_id=”8n37145mme”][cmsmasters_image shortcode_id=”4kzlakzedi” align=”none” animation_delay=”0″ classes=”cmsmasters_image_n”]17808|https://www.kanishkhospital.com/wp-content/uploads/2023/03/Importance-of-Vitamin-D-in-Calcium-Homeostasis.jpg|full[/cmsmasters_image][/cmsmasters_column][/cmsmasters_row][cmsmasters_row][cmsmasters_column data_width=”1/1″][cmsmasters_text]

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”z1mzedhr9″][cmsmasters_column data_width=”1/2″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”mtizhe9vg8″][cmsmasters_heading shortcode_id=”8y2uzvcg45″ type=”h3″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Stages of Vitamin D Deficiency[/cmsmasters_heading][cmsmasters_text shortcode_id=”xneh2gulw” animation_delay=”0″]

The severity of vitamin D deficiency is divided into following stages:

• Mild deficiency: 25-hydroxyvitamin D <20 ng/mL
• Moderate deficiency: 25-hydroxyvitamin D <10 ng/mL
• Severe deficiency: 25-hydroxyvitamin D <5 ng/mL

[/cmsmasters_text][/cmsmasters_column][cmsmasters_column data_width=”1/2″ data_shortcode_id=”cik17pswum”][cmsmasters_image shortcode_id=”avx2icheje” align=”none” animation_delay=”0″ classes=”cmsmasters_image_n”]17806|https://www.kanishkhospital.com/wp-content/uploads/2023/03/Vitamin-D-Deficiency.jpg|full[/cmsmasters_image][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_shortcode_id=”jj3sm57fe” data_width=”boxed” data_padding_left=”3″ data_padding_right=”3″ data_top_style=”default” data_bot_style=”default” data_color=”default” data_bg_position=”top center” data_bg_repeat=”no-repeat” data_bg_attachment=”scroll” data_bg_size=”cover” data_bg_parallax_ratio=”0.5″ data_padding_top=”0″ data_padding_bottom=”50″ data_padding_top_large=”0″ data_padding_bottom_large=”0″ data_padding_top_laptop=”0″ data_padding_bottom_laptop=”0″ data_padding_top_tablet=”0″ data_padding_bottom_tablet=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_v=”0″][cmsmasters_column data_width=”1/2″ data_shortcode_id=”3xmofqmp1″ data_bg_position=”top center” data_bg_repeat=”no-repeat” data_bg_attachment=”scroll” data_bg_size=”cover” data_border_style=”default” data_animation_delay=”0″][cmsmasters_heading shortcode_id=”0pv7j613uc” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Etiology of Vitamin D Deficiency[/cmsmasters_heading][cmsmasters_text shortcode_id=”415c41a5lp” animation_delay=”0″]

1. Decreased dietary intake and/or absorption
2. Decreased sun exposure
3. Decreased endogenous synthesis
4. Increased hepatic catabolism
5. End organ resistance

[/cmsmasters_text][/cmsmasters_column][cmsmasters_column data_width=”1/2″ data_shortcode_id=”tqpp6wzrou”][cmsmasters_image shortcode_id=”0oz754m1ro” align=”none” animation_delay=”0″]17810|https://www.kanishkhospital.com/wp-content/uploads/2023/03/Etiology-of-Vitamin-D-Deficiency.jpg|full[/cmsmasters_image][/cmsmasters_column][/cmsmasters_row][cmsmasters_row][cmsmasters_column data_width=”1/1″][cmsmasters_text]

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[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_shortcode_id=”agcgxon16″ data_width=”boxed” data_padding_left=”3″ data_padding_right=”3″ data_top_style=”default” data_bot_style=”default” data_color=”default” data_bg_position=”top center” data_bg_repeat=”no-repeat” data_bg_attachment=”scroll” data_bg_size=”cover” data_bg_parallax_ratio=”0.5″ data_padding_top=”0″ data_padding_bottom=”50″ data_padding_top_large=”0″ data_padding_bottom_large=”0″ data_padding_top_laptop=”0″ data_padding_bottom_laptop=”0″ data_padding_top_tablet=”0″ data_padding_bottom_tablet=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_v=”0″][cmsmasters_column data_width=”1/2″ data_shortcode_id=”a9tl3hhzk1″ data_bg_position=”top center” data_bg_repeat=”no-repeat” data_bg_attachment=”scroll” data_bg_size=”cover” data_border_style=”default” data_animation_delay=”0″][cmsmasters_heading shortcode_id=”z338jyzd9″ type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Pathogenesis of Bone Diseases and Plausible Role of Vitamin D[/cmsmasters_heading][cmsmasters_text shortcode_id=”cbek23l8n” animation_delay=”0″]

1. Role of Vitamin D in Pathogenesis of Osteomalacia (1/2)Hypovitaminosis D
   • Prolonged secondary hyperparathyroidism
   • Net loss of cortical bone on the endosteal surface
   • Irreversible cortical porosity and thinning of cortical bone
     Well-maintained trabecular bone mass

[/cmsmasters_text][/cmsmasters_column][cmsmasters_column data_width=”1/2″ data_shortcode_id=”ykhoatvvq”][/cmsmasters_column][/cmsmasters_row][cmsmasters_row][cmsmasters_column data_width=”1/1″][cmsmasters_text]

• Absolute deficiency of vitamin D
  
• Skeleton replaced by unmineralized osteoid
• Weight-bearing bones begin to bend
• Stretching of periosteum
• Painful condition

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_shortcode_id=”71y616u8ac” data_width=”boxed” data_padding_left=”3″ data_padding_right=”3″ data_top_style=”default” data_bot_style=”default” data_color=”default” data_bg_position=”top center” data_bg_repeat=”no-repeat” data_bg_attachment=”scroll” data_bg_size=”cover” data_bg_parallax_ratio=”0.5″ data_padding_top=”0″ data_padding_bottom=”50″ data_padding_top_large=”0″ data_padding_bottom_large=”0″ data_padding_top_laptop=”0″ data_padding_bottom_laptop=”0″ data_padding_top_tablet=”0″ data_padding_bottom_tablet=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_v=”0″][cmsmasters_column data_width=”1/2″ data_shortcode_id=”kcxkjcuqr7″ data_bg_position=”top center” data_bg_repeat=”no-repeat” data_bg_attachment=”scroll” data_bg_size=”cover” data_border_style=”default” data_animation_delay=”0″][cmsmasters_heading shortcode_id=”a1th7aidn” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Role of Vitamin D in Pathogenesis of Osteomalacia (2/2)[/cmsmasters_heading][cmsmasters_text shortcode_id=”621rfpxy9a” animation_delay=”0″]

1. Three phases of HVO are as following:
   • Secondary hyperparathyroidism increases the osteoid accumulation due to increased bone turnover (HVOi/Preosteomalacia)
   • Delay in mineralization of osteoid such that only the earliest formed matrix becomes mineralized (HVOii)
   • None of the matrix formed becomes mineralized (HVOii)

[/cmsmasters_text][/cmsmasters_column][cmsmasters_column data_width=”1/2″ data_shortcode_id=”1ompwph2bo”][cmsmasters_image shortcode_id=”2e9rm758k” align=”none” animation_delay=”0″]17830|https://www.kanishkhospital.com/wp-content/uploads/2023/03/Role-of-Vitamin-D-in-Pathogenesis-300×300.jpg|medium[/cmsmasters_image][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_shortcode_id=”rmoa4pq054″ data_width=”boxed” data_padding_left=”3″ data_padding_right=”3″ data_top_style=”default” data_bot_style=”default” data_color=”default” data_bg_position=”top center” data_bg_repeat=”no-repeat” data_bg_attachment=”scroll” data_bg_size=”cover” data_bg_parallax_ratio=”0.5″ data_padding_top=”0″ data_padding_bottom=”50″ data_padding_top_large=”0″ data_padding_bottom_large=”0″ data_padding_top_laptop=”0″ data_padding_bottom_laptop=”0″ data_padding_top_tablet=”0″ data_padding_bottom_tablet=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_v=”0″][cmsmasters_column data_width=”1/2″ data_shortcode_id=”yshlxk4z5o” data_bg_position=”top center” data_bg_repeat=”no-repeat” data_bg_attachment=”scroll” data_bg_size=”cover” data_border_style=”default” data_animation_delay=”0″][cmsmasters_heading shortcode_id=”fo96wwjtbi” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Pathogenesis of Osteoporosis[/cmsmasters_heading][cmsmasters_text shortcode_id=”gobcrg26w” animation_delay=”0″]

1. Osteoporosis can occur because of: Failure to achieve peak bone mass
   • Genetic factors
   • Hormonal status
   • Environmental factors (nutrition, exercise, and smoking) Intrauterine factors (maternal nutrition, smoking, and level of exercise)

    

   Excessive bone resorption and/or decreased bone formation during remodeling

   • Reduction in the number of osteoprogenitor/pre-osteoblastic cells and/or an age-related defect in their proliferative and differentiation abilities

[/cmsmasters_text][/cmsmasters_column][cmsmasters_column data_width=”1/2″ data_shortcode_id=”4n5c54z5k”][cmsmasters_image shortcode_id=”dk2mr8yq2u” align=”none” animation_delay=”0″]17831|https://www.kanishkhospital.com/wp-content/uploads/2023/03/Pathogenesis-of-Osteoporosis-300×300.jpg|medium[/cmsmasters_image][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_shortcode_id=”05z0mxgnaj” data_width=”boxed” data_padding_left=”3″ data_padding_right=”3″ data_top_style=”default” data_bot_style=”default” data_color=”default” data_bg_position=”top center” data_bg_repeat=”no-repeat” data_bg_attachment=”scroll” data_bg_size=”cover” data_bg_parallax_ratio=”0.5″ data_padding_top=”0″ data_padding_bottom=”50″ data_padding_top_large=”0″ data_padding_bottom_large=”0″ data_padding_top_laptop=”0″ data_padding_bottom_laptop=”0″ data_padding_top_tablet=”0″ data_padding_bottom_tablet=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_v=”0″][cmsmasters_column data_width=”1/2″ data_shortcode_id=”7kacihbtmt” data_bg_position=”top center” data_bg_repeat=”no-repeat” data_bg_attachment=”scroll” data_bg_size=”cover” data_border_style=”default” data_animation_delay=”0″][cmsmasters_heading shortcode_id=”1yxvjcftt” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Role of Vitamin D in Pathogenesis of Osteoarthritis[/cmsmasters_heading][cmsmasters_text shortcode_id=”xe58b4jvp” animation_delay=”0″]

1. The effects of vitamin D on several different cell types in osteoarthritis including chondrocytes, osteoclasts, and osteoblasts.Osteoclasts
   • Increased bone resorption

   Osteoblasts

   • Increased proliferation
     • Increased bone formation and mineralization
     • Increased angiogenesis

     Chondrocytes

     • Increased expression of VDR
     • Increased MMP expression
     • Cartilage and bone degradation
     • Hypertrophy and reduced mineralization

[/cmsmasters_text][/cmsmasters_column][cmsmasters_column data_width=”1/2″ data_shortcode_id=”d3lsqa3o6g”][cmsmasters_image shortcode_id=”hb1ho9ev5e” align=”none” animation_delay=”0″]17835|https://www.kanishkhospital.com/wp-content/uploads/2023/03/Role-of-Vitamin-D-in-Pathogenesis-of-Osteomalacia-12-300×300.jpg|medium[/cmsmasters_image][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_shortcode_id=”u8r4lui6vm” data_width=”boxed” data_padding_left=”3″ data_padding_right=”3″ data_top_style=”default” data_bot_style=”default” data_color=”default” data_bg_position=”top center” data_bg_repeat=”no-repeat” data_bg_attachment=”scroll” data_bg_size=”cover” data_bg_parallax_ratio=”0.5″ data_padding_top=”0″ data_padding_bottom=”50″ data_padding_top_large=”0″ data_padding_bottom_large=”0″ data_padding_top_laptop=”0″ data_padding_bottom_laptop=”0″ data_padding_top_tablet=”0″ data_padding_bottom_tablet=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_v=”0″][cmsmasters_column data_width=”1/2″ data_shortcode_id=”19s33n3onp” data_bg_position=”top center” data_bg_repeat=”no-repeat” data_bg_attachment=”scroll” data_bg_size=”cover” data_border_style=”default” data_animation_delay=”0″][cmsmasters_heading shortcode_id=”8ill87m4qc” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Pathogenesis of Fractures[/cmsmasters_heading][cmsmasters_text shortcode_id=”iwhpg8zkfk” animation_delay=”0″]

1. Fracture, a complication of osteoporosis, occurs in patients with decreased bone strength and who experience an injury.
   • Low bone mass
   • Poor bone quality
   • Bone turnover rate
   • Age
   • Effects of falls
   • Mechanics of falling
   • Frequency of falls
   • Other injuries

[/cmsmasters_text][/cmsmasters_column][cmsmasters_column data_width=”1/2″ data_shortcode_id=”dlis8whsud”][cmsmasters_image shortcode_id=”tklwl8wsfm” align=”none” animation_delay=”0″]17836|https://www.kanishkhospital.com/wp-content/uploads/2023/03/Pathogenesis-of-Fractures-300×300.jpg|medium[/cmsmasters_image][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_shortcode_id=”grolvgoaf” data_width=”boxed” data_padding_left=”3″ data_padding_right=”3″ data_top_style=”default” data_bot_style=”default” data_color=”default” data_bg_position=”top center” data_bg_repeat=”no-repeat” data_bg_attachment=”scroll” data_bg_size=”cover” data_bg_parallax_ratio=”0.5″ data_padding_top=”0″ data_padding_bottom=”50″ data_padding_top_large=”0″ data_padding_bottom_large=”0″ data_padding_top_laptop=”0″ data_padding_bottom_laptop=”0″ data_padding_top_tablet=”0″ data_padding_bottom_tablet=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_v=”0″][cmsmasters_column data_width=”1/1″ data_shortcode_id=”iww8nxsbim” data_bg_position=”top center” data_bg_repeat=”no-repeat” data_bg_attachment=”scroll” data_bg_size=”cover” data_border_style=”default” data_animation_delay=”0″][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_shortcode_id=”el2nftvgnc” data_width=”boxed” data_padding_left=”3″ data_padding_right=”3″ data_top_style=”default” data_bot_style=”default” data_color=”default” data_bg_position=”top center” data_bg_repeat=”no-repeat” data_bg_attachment=”scroll” data_bg_size=”cover” data_bg_parallax_ratio=”0.5″ data_padding_top=”0″ data_padding_bottom=”50″ data_padding_top_large=”0″ data_padding_bottom_large=”0″ data_padding_top_laptop=”0″ data_padding_bottom_laptop=”0″ data_padding_top_tablet=”0″ data_padding_bottom_tablet=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_v=”0″][cmsmasters_column data_width=”1/1″ data_shortcode_id=”3saohpoi28″ data_bg_position=”top center” data_bg_repeat=”no-repeat” data_bg_attachment=”scroll” data_bg_size=”cover” data_border_style=”default” data_animation_delay=”0″][cmsmasters_heading shortcode_id=”5ee0ak3niq” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Who Needs Vitamin D Supplementation?[/cmsmasters_heading][cmsmasters_text shortcode_id=”5mtf2hgb7m” animation_delay=”0″]

Vitamin D supplementation is needed in the following people:

• Elderly people (>65 years old)
• People with a prevalent fragility fracture
• People who are taking anti-osteoporotic drug therapy
• People who are at risk of reduced assumption and/or absorption of dietary calcium
• People who are taking corticosteroids or other drugs, which can induce osteoporosis
• People with a deficit of vitamin D due to liver or kidney severe diseases
• People with rickets or osteomalacia

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_shortcode_id=”fx3a4gmqvn” data_width=”boxed” data_padding_left=”3″ data_padding_right=”3″ data_top_style=”default” data_bot_style=”default” data_color=”default” data_bg_position=”top center” data_bg_repeat=”no-repeat” data_bg_attachment=”scroll” data_bg_size=”cover” data_bg_parallax_ratio=”0.5″ data_padding_top=”0″ data_padding_bottom=”50″ data_padding_top_large=”0″ data_padding_bottom_large=”0″ data_padding_top_laptop=”0″ data_padding_bottom_laptop=”0″ data_padding_top_tablet=”0″ data_padding_bottom_tablet=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_v=”0″][cmsmasters_column data_width=”1/2″ data_shortcode_id=”lnvwhlt1ko” data_bg_position=”top center” data_bg_repeat=”no-repeat” data_bg_attachment=”scroll” data_bg_size=”cover” data_border_style=”default” data_animation_delay=”0″][cmsmasters_heading shortcode_id=”yi9m6xohg” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Bone Mineral Density: A Predictive Factor for Fracture Risk Reduction[/cmsmasters_heading][cmsmasters_text shortcode_id=”ndfsvw775a” animation_delay=”0″]

1. Relationship between BMD and fracture risk
   • As bone mass decreases, fracture risk increases exponentially.
   • For every SD decrease in bone density, the risk of osteoporotic fracture increases by 1.5–2 times.
   • Hip fracture risk increases by 2.6-fold for every SD decrease in hip density.

[/cmsmasters_text][/cmsmasters_column][cmsmasters_column data_width=”1/2″ data_shortcode_id=”lfu6a8yyo”][cmsmasters_image shortcode_id=”zhg7ew05uc” align=”none” animation_delay=”0″]17840|https://www.kanishkhospital.com/wp-content/uploads/2023/03/Bone-Mineral-Density-A-Predictive-Factor-for-Fracture-Risk-Reduction-300×300.jpg|medium[/cmsmasters_image][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”xw7z3p2r4a”][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”4hlmxmtmv”][cmsmasters_heading shortcode_id=”gbajwghob” type=”h1″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Burden of Vitamin D Deficiency: The Global Scenario[/cmsmasters_heading][cmsmasters_heading shortcode_id=”rbgw1npna8″ type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Vitamin D Deficiency: A Global Phenomenon[/cmsmasters_heading][cmsmasters_text shortcode_id=”ik4byoz5m” animation_delay=”0″]

• Vitamin D deficiency is a global public health issue.
• About 1 billion people worldwide have vitamin D deficiency.
• Vitamin D deficiency is the highest in the elderly, obese patients, nursing home residents, and hospitalized patients.

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”sfcsxcmgye”][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”nu1ai7wni”][cmsmasters_heading shortcode_id=”waghfqo6dp” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Vitamin D Deficiency: Across Age Groups[/cmsmasters_heading][cmsmasters_text shortcode_id=”xqo8aw8kr” animation_delay=”0″]

• Infants
  • US: 47% of African American infants and 56% of Caucasian infants have vitamin D deficiency
  • Iran, Turkey, and India: 90% of infants have vitamin D deficiency

   

  Adults

  • US: 35% of adults are vitamin D deficient
  • Pakistan, India, and Bangladesh: Over 80% of adults are vitamin D deficient

   

  Elderly

  • US: 61% of the elderly population is vitamin D deficient.
  • 90% in Turkey, 96% in India, 72% in Pakistan, and 67% in Iran are vitamin D deficient.

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”kj30cacpg”][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”o8qbsow61″][cmsmasters_heading shortcode_id=”nl3aimqxtn” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Prevalence of Vitamin D Deficiency in Children With Osteopenia/Osteoporosis [/cmsmasters_heading][cmsmasters_text shortcode_id=”rkhbjtmpb” animation_delay=”0″]

• A retrospective study including 85 children aimed at determining the prevalence of vitamin D deficiency and insufficiency in children with osteopenia or osteoporosis.Vitamin D insufficiency was remarkably common in pediatric patients with primary and secondary osteopenia or osteoporosis.

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”sv7645awk”][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”71xy8pxrli”][cmsmasters_heading shortcode_id=”o1t3n5yo0t” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Prevalence of Vitamin D Deficiency in Osteoarthritis[/cmsmasters_heading][cmsmasters_text shortcode_id=”d57jvcj97h” animation_delay=”0″]

• Osteoarthritis is the single most common cause of disability in older adults.
  • 10% to 15% of all adults aged over 60 have some degree of OA, with prevalence higher among women than men.
  • By 2050 130 million people will have osteoarthritis

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”63mennwcy”][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”vf63ih8bq6″][cmsmasters_heading shortcode_id=”nutubgshu” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Prevalence of Fractures[/cmsmasters_heading][cmsmasters_text shortcode_id=”u6hn8e83a” animation_delay=”0″]

• Globally, about 9 million people with osteoporosis have a fracture annually.
• Fractures caused by osteoporosis occur in one-third of females and one-fifth of males over 50 years.
• About 5%–10% of all fractures display disturbed bone healing.

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”7887ubnysn”][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”yxzjk1obk”][cmsmasters_heading shortcode_id=”3v64497wu” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Prevalence of Vitamin D Inadequacy in a Minimal Trauma Fracture Population[/cmsmasters_heading][cmsmasters_text shortcode_id=”5gs26zb3k5″ animation_delay=”0″]

• A study enrolled 82 adults (age 52–97 with 63% aged above 80) who were hospitalized with hip and extremity fractures.Nearly all patients in this study, hospitalized for a minimal trauma fracture, had vitamin D inadequacy.There is a high prevalence of vitamin D inadequacy among in people hospitalized for a minimal trauma fracture in the U.S.

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”njk7inpps2″][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”z79157p4qi”][cmsmasters_heading shortcode_id=”q669njfhee” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Prevalence of Hypovitaminosis D Among Elderly Patients With Fractures due to Trivial Injury[/cmsmasters_heading][cmsmasters_text shortcode_id=”zwj2s0jboa” animation_delay=”0″]

• A cross-sectional study that enrolled patients above 45 years, presenting with fracture as a result of trivial trauma reported the following prevalence of vitamin D deficiency:The majority of the subjects (94.1%) had low serum vitamin D levels.There is a high prevalence of vitamin D insufficiency among the elderly patients presenting with fractures due to minor injuries.

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”1brt1j5g9″][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”17ybv9p714″][cmsmasters_heading shortcode_id=”3gah1nz4hg” type=”h1″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Vitamin D Supplementation in Bone Diseases and Fractures: Clinical Evidence[/cmsmasters_heading][cmsmasters_heading shortcode_id=”2xc1kjpoxj” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Vitamin D Supplementation Prevents Fall and Fracture[/cmsmasters_heading][cmsmasters_text shortcode_id=”690vdicn7o” animation_delay=”0″]

• A meta-analysis of 47 trials with 58,424 participants in which the major populations were elderly women with age less than 80 years showed:
  • Vitamin D along with calcium supplement significantly lowers fracture rates (p=0.045).
  • Use of vitamin D supplement, especially vitamin D3 could reduce incidence of fall.

  Vitamin D₃ supplement (≥800 IU per day) combined with calcium can prevent falls and fractures.

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”nvxhc34nyg”][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”a8swtn0ae”][cmsmasters_heading shortcode_id=”n4gkt4dqw” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″] Relation of Vitamin D Levels With Lower Extremity Function[/cmsmasters_heading][cmsmasters_text shortcode_id=”9w1knsuiw” animation_delay=”0″]

• NHANES III study enrolled 4100 ambulatory elderly population aged over 60 years.
  • Sharp functional decline in the walk test and chair stand test when 25(OH)D levels fell below 50 nmol/L.
  • Physical performance improved with increasing 25(OH)D up to 50 nmol/L.

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”p5h4sejxak”][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”5c61gbuyjk”][cmsmasters_heading shortcode_id=”3ttazfmeul” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Effect of Vitamin D on Bone Density and Fractures in Postmenopausal Osteoporosis[/cmsmasters_heading][cmsmasters_text shortcode_id=”kck3grfjc7″ animation_delay=”0″]

• A meta-analysis included 25 trials that randomized women with postmenopausal osteoporosis to standard or hydroxylated vitamin D with or without calcium supplementation or a control and measured bone density or fracture incidence for at least 1 year.
  • Vitamin D supplementation reduced the incidence of vertebral fractures (p<0.01).
  • Vitamin D supplementation reduced incidence of nonvertebral fractures (p=0.09).

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”cg920fwt3h”][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”n4twaab366″][cmsmasters_heading shortcode_id=”xp60v68lxe” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Vitamin D Supplementation Improves Physical Performance in Osteoarthritis Patients (1/2)[/cmsmasters_heading][cmsmasters_text shortcode_id=”9sckazh23a” animation_delay=”0″]

• Patients with primary knee OA and low levels of serum 25(OH)D (<30 ng/mL) (n=175) were supplemented with  40,000 IU vitamin D2 (ergocalciferol) per week for six months.
  • Vitamin D2 supplementation improved grip strength and physical performance (p<0.05)
    Vitamin D₂ supplementation (40,000 IU per week) strength and physical strength improves grip performance in patients with knee OA. 

     

    .

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”ogvvt2har”][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”ij3tm1y8bo”][cmsmasters_heading shortcode_id=”vc9ncn0qab” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]High Prevalence of Hypovitaminosis D Among Orthopedic Surgery Patients[/cmsmasters_heading][cmsmasters_text shortcode_id=”gsqikxwzp” animation_delay=”0″]

• Prevalence of 25(OH)D insufficiency and deficiency among the different orthopedic services: A single-center analysisA retrospective chart review of 723 patients scheduled for orthopedic surgery showed that:
  • 43% of all patients had insufficient serum vitamin D levels
  • 40% had deficient levels.

  Prevalence of low serum levels of vitamin D among patients undergoing orthopedic surgery is very common.

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”mch2qbx6lv”][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”4i451hhp4″][cmsmasters_heading shortcode_id=”t4h782sph9″ type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Vitamin D Status Among Postmenopausal Osteoporotic Women[/cmsmasters_heading][cmsmasters_text shortcode_id=”liukekminp” animation_delay=”0″]

• Vitamin D status (prevalence) among postmenopausal women with suspected osteoporosisVitamin D level-
  • Sufficient Level 36.2
  • InSufficient Level 44.8
  • Deficient Level 19

  Percentage with 95% CI

  Common musculoskeletal symptoms among postmenopausal women

  Symptoms

  • Proximal myopathy 40%
  • Muscle cramps 43.8%
  • Malaise 51.4
  • Easy Fatigability 54.3%
  • Bone-pain 55.2
  • Paraesthesia 57.1

  Percentage with 95% CI

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”c55ne9p234″][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”wmsmuyqqo”][cmsmasters_heading shortcode_id=”bhphbti63″ type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Effect of Vitamin D Status on Fracture Healing[/cmsmasters_heading][cmsmasters_text shortcode_id=”b1t82zozmr” animation_delay=”0″]

• In patients with a vitamin D deficiency more delayed union was described clinically, although the incidence of radiological delayed union did not depend on vitamin D status.

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”2v5ya11dyl”][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”r81q9qfxd8″][cmsmasters_heading shortcode_id=”y6gcigtt2q” type=”h1″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Recommendations and Guidelines for Vitamin D Supplementation for Management of Bone Diseases[/cmsmasters_heading][cmsmasters_heading shortcode_id=”p1zkjvdiik” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Summary of Guidelines for Vitamin D Supplementation [/cmsmasters_heading][cmsmasters_text shortcode_id=”bgxh8x5sq” animation_delay=”0″]

Vitamin D intake may be recommended from a combination of dietary sources (including fortified foods) and/or supplementation, depending on the country/region, age group and season

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”6mvzyyg5ta”][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”ca1qp18o9″][cmsmasters_heading shortcode_id=”mzmyadkqhs” type=”h1″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Benefits of Vitamin D Supplementation in Orthopedics: Case Presentations[/cmsmasters_heading][cmsmasters_heading shortcode_id=”rrkozxmhhz” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Orthopedic Trauma: Hip Fracture in Elderly[/cmsmasters_heading][cmsmasters_heading shortcode_id=”ens5ve014p” type=”h3″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Case Presentations[/cmsmasters_heading][cmsmasters_text shortcode_id=”u0nid4ggb9″ animation_delay=”0″]

• A 65-year–old male patient presented with ipsilateral pain in his right hip caused by a fall while he was jogging in the morning making it unable to ambulate.

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”b87fzz50hf”][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”p9g0enwhe”][cmsmasters_heading shortcode_id=”wchhtdyvr” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Case History[/cmsmasters_heading][cmsmasters_heading shortcode_id=”51l419i63f” type=”h3″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Past medical history[/cmsmasters_heading][cmsmasters_text shortcode_id=”ryvw8t7q7e” animation_delay=”0″]

• • His past medical history included psoriasis, for which he had been using calcipotriol ointment and had also used topical steroids occasionally.
  • He also had asthma for which he had taken several short courses of oral prednisone, which had been mostly 5-day prescriptions of 50 mg.
  • He had no history of hypertension or cardiovascular disease.

   

  Personal history

  • He was a nonsmoker and a teetotaller.
  • He was a vegetarian who had yogurt two to three times weekly and milk in his tea twice daily.

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”gacliy32qe”][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”ybje5x93fp”][cmsmasters_heading shortcode_id=”6nyv0pvnif” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Clinical Examination [/cmsmasters_heading][cmsmasters_text shortcode_id=”wo1epbj0vd” animation_delay=”0″]

• • Physical examination-
    • Patient was conscious.
    • On palpation edema was observed but there was no injury.

    Vital signs

    • Pulse rate: 48 beats/min; irregular
    • Blood pressure: 95/60 mmHg
    • Temperature: 98.4°C

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”vz4w6khl2n”][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”ag2ptycijw”][cmsmasters_heading shortcode_id=”y48if1ojgn” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Radiological Investigation[/cmsmasters_heading][cmsmasters_text shortcode_id=”vbal6eouq” animation_delay=”0″]

• • X-rays
    • Right superior–posterior hip dislocation with a Pipkin Type 2 fracture of the femoral head

    CT scan

    • Posteromedial fracture of the right femoral head; excluded acetabular fractures

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”dnejrsr007″][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”57l75li6ss”][cmsmasters_heading shortcode_id=”lk2lwpe2cc” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Laboratory Investigations[/cmsmasters_heading][cmsmasters_text shortcode_id=”vy16359omn” animation_delay=”0″]

• • Normal full blood count, electrolytes, albumin, renal function, liver function, thyroid function, erythrocyte sedimentation rate, celiac screen, prolactin, testosterone, and prostate-specific antigen.
  • Bone densitometry showed T-scores of −2.0 at the spine, −3.5 at the femoral neck, and −2.4 for the total hip
    Parameters- 

     

    • 25-hydroxyvitamin D
    • Parathyroid hormone
    • Calcium (albumin adjusted)
    • Alkaline phosphatase
    • Procollagen 1 N-terminal propeptide

     

    Observed values

    • 1 ng/mL (normal range: 30–100 ng/mL)
    • 35 pmol/L (normal range: 1.7–7.3 pmol/L)
    • 92 mmol/L (normal range: 2.10–2.55 mmol/L)
    • 132 U/L (normal range: 40–120 U/L)
    •  
    • 118 μg/L (normal range: 20–85 μg/L)

    Diagnosis, Management, and Follow-up

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”0r6m82mm1″][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”07iuhep72q”][cmsmasters_heading shortcode_id=”mzw0rr2x3o” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Diagnosis, Management, and Follow-up[/cmsmasters_heading][cmsmasters_text shortcode_id=”k1txzl699″ animation_delay=”0″]

• • DiagnosisA diagnosis of vitamin D insufficiency fracture resulting from osteoporosis was made.Treatment
    • Surgical correction was carried out.
    • The patient was started on calcium carbonate 1.25 g twice daily post surgery and vitamin D3 60,000 IU orally weekly for 8 weeks as he was diagnosed with hypovitaminosis D, followed by a maintenance therapy of 60,000 IU per month for the next the 6 months.
    • He was instructed to do some exercises along with lifestyle changes.

     

    Follow-up

    At 2 months post operation, the patient was pain free and able to ambulate without aid.

    Follow-up X-rays showed satisfactory alignment with no evidence of osteonecrosis.

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”r0nm00clt”][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”88rw6n1rs4″][cmsmasters_heading shortcode_id=”dk6vaeex56″ type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Summary: Orthopedic Trauma—Hip Fracture in Elderly[/cmsmasters_heading][cmsmasters_text shortcode_id=”q15ml6rn45″ animation_delay=”0″]

• • An orthopedic surgery, vitamin D3 and calcium supplementation, correct nutrition, physical exercise, and also a rapid and appropriate anti-osteoporosis treatment can ensure optimal recovery and survival, especially in hip-fractured patients.Treatment
    • Surgical correction
    • 6 months course of vitamin D3 (60,000 IU/week
    • Calcium carbonate 1.25 g twice daily post surgery
    • Nutritional advice
    • Good recovery noted

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”fe60ej5uus”][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”g1o3y5sdnb”][cmsmasters_heading shortcode_id=”oomcbzhj1a” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Nonunion Fracture: Case Presentation[/cmsmasters_heading][cmsmasters_text shortcode_id=”zie3lzeu6d” animation_delay=”0″]

• • Case PresentationHistory of presenting illness-
    • A 50-year–old female patient presented with pain while putting weight on her lower leg.

     

    Case History

     

    Past medical history

    • She had undergone an operation 7 months before for a fracture on the same leg, which had been caused by a fall.
    • A plate osteosynthesis of the fibula and tibia had been performed to treat the patient’s distal lower leg fracture 7 months before.
    • There had been no post-operation complications or infections.
    • She had no history of hypertension or cardiovascular disease.
      Personal history 

       

      • She was a nonsmoker and teetotaller.
      • She did not exercise regularly and led a sedentary lifestyle.

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”wp736jqgc3″][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”si1uhj8sa”][cmsmasters_heading shortcode_id=”7qotyonr8″ type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Clinical Examination- [/cmsmasters_heading][cmsmasters_text shortcode_id=”cn001fbzx” animation_delay=”0″]

• • Physical examination
    • Patient was conscious.

    Vital signs

    • Pulse rate: 60–80 beats/min; irregular
    • Blood pressure: 95/60 mmHg

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”g9zxrnr68k”][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”lgkvabqb4q”][cmsmasters_heading shortcode_id=”9lynddj8td” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Radiological Investigation[/cmsmasters_heading][cmsmasters_text shortcode_id=”kwks43k8sm” animation_delay=”0″]

• • X-rays
    • Visible fracture gaps 7 months after fracture.
    • The edges of the fractures showed increasing sclerosis with no bone bridges in the fracture gap.
    • Still inadequate callus formation.

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”0aite9akmq”][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”tpcb47qpk9″][cmsmasters_heading shortcode_id=”mei8fiv6c” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Laboratory Investigations[/cmsmasters_heading][cmsmasters_text shortcode_id=”1npx8gtbxf” animation_delay=”0″]

• • Normal full blood count, electrolytes, albumin, renal function, liver function, thyroid function, and erythrocyte sedimentation rate.Bone mineral density (BMD) and T-Score in her lumber (L2-4), femoral neck, and distal radius (1/3) regions were all decreased (0.688 g/cm2 and −2.9 SD, 0.578 g/cm2 and −1.9 SD, and 0.449 g/cm2 and −3.4 SD, respectively).Parameters
    • 25-hydroxyvitamin D
    • Parathyroid hormone
    • Calcium (albumin adjusted)
    • Alkaline phosphatase
    • Procollagen 1 N-terminal propeptide

    Observed values

    • 1 ng/mL (normal range: 30–100 ng/mL)
    • 35 pmol/L (normal range: 1.7–7.3 pmol/L)
    • 76 mmol/L (normal range: 2.10–2.55 mmol/L)
    • 132 U/L (normal range: 40–120 U/L)
    • 118 μg/L (normal range: 20–85 μg/L)

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”55vkslkfh”][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”9mrguf2qbi”][cmsmasters_heading shortcode_id=”67ggkwzxkc” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″] Diagnosis, Management, and Follow-up[/cmsmasters_heading][cmsmasters_text shortcode_id=”uou8tvfmf” animation_delay=”0″]

• • DiagnosisDiagnosis of an oligotrophic delayed union was made.Management

    She was prescribed vitamin D3 60,000IU per week for 8 weeks and then per month for 6 months in addition to calcium carbonate 1.25 g twice daily with nutritional advice.

    Follow-up

    • Osseous consolidation of the fractures was observed indicated by bone bridges within the fracture gap.
    • Upon complete and pain-free weight bearing of the leg, the osteosynthesis material was removed.
    • The patient remained free of symptoms.

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”smaekqg6r8″][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”k6fo2qr8sj”][cmsmasters_heading shortcode_id=”10vd5a39b9″ type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Summary: Nonunion Fracture[/cmsmasters_heading][cmsmasters_text shortcode_id=”0h1e8bdn3″ animation_delay=”0″]

• • The patient was diagnosed with an oligotrophic delayed union fracture; laboratory tests revealed severe vitamin D deficiency for which vitamin D3 and calcium supplementation were prescribed for 4 months along with nutritional advice, which resulted in an optimal recovery.Summary
    • 4-month course of vitamin D3 (60,000 IU)/day
    • Calcium carbonate 1.25 g twice daily
    • Nutritional advice
    • Osseous consolidation of the fractures
    • Patient remained free of symptoms for 4 months
    • Good recovery noted

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”aloibhdcka”][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”g5s68zwfyi”][cmsmasters_heading shortcode_id=”fiy58yl05q” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Discussion Questions[/cmsmasters_heading][cmsmasters_text shortcode_id=”fwrjbck3n” animation_delay=”0″]

• • Why is Vitamin D supplementation important in fractured patients?
  • Vitamin D supplementation in a fractured patient: When?
  • Vitamin D supplementation in a fractured patient: How and how much?

[/cmsmasters_text][/cmsmasters_column][/cmsmasters_row][cmsmasters_row data_padding_bottom_mobile_v=”0″ data_padding_top_mobile_v=”0″ data_padding_bottom_mobile_h=”0″ data_padding_top_mobile_h=”0″ data_padding_bottom_tablet=”0″ data_padding_top_tablet=”0″ data_padding_bottom_laptop=”0″ data_padding_top_laptop=”0″ data_padding_bottom_large=”0″ data_padding_top_large=”0″ data_padding_bottom=”50″ data_padding_top=”0″ data_bg_parallax_ratio=”0.5″ data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_color=”default” data_bot_style=”default” data_top_style=”default” data_padding_right=”3″ data_padding_left=”3″ data_width=”boxed” data_shortcode_id=”emqrfs7j2a”][cmsmasters_column data_width=”1/1″ data_animation_delay=”0″ data_border_style=”default” data_bg_size=”cover” data_bg_attachment=”scroll” data_bg_repeat=”no-repeat” data_bg_position=”top center” data_shortcode_id=”3suyg9qoa”][cmsmasters_heading shortcode_id=”vytwm41azk” type=”h2″ font_weight=”default” font_style=”default” text_align=”left” margin_top=”0″ margin_bottom=”20″ animation_delay=”0″]Key Messages[/cmsmasters_heading][cmsmasters_text shortcode_id=”3o3q2q8bz” animation_delay=”0″]

• • Vitamin D is a proven and internationally recommended agent for the management of bone diseases and fractures.
    • Vitamin D is an important component for maintaining good skeletal health.
    • Vitamin D deficiency is a global public health issue, which leads to the pathogenesis of diseases, such as osteoporosis, osteoarthritis, and osteomalacia, and increases the frequency of fractures.
    • Various guidelines recommend vitamin D supplementation for the alleviation of bone diseases and reduction and treatment of fractures.

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