Prevalence of vitamin D insufficiency in children with forearm fractures

Sağlam, Yavuz; Kizildag, H.; Toprak, Güvenç; Alp, Nazmi; Yalcinkaya, E. Y.

doi:10.1302/1863-2548.11.160008

Cited by 18 publications

(3 citation statements)

References 30 publications

(49 reference statements)

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“…32 The consequence of this process is a poor bone quality which in turn leads to a higher fracture risk at the end of winter. 33,34 While this effect might be more subtle in countries like Israel where winters are mild and the UVB exposure is consistently higher, 30,35 in areas that have long and dark winters children might begin their spring sports activities with more vulnerable bones. 3,16,33 During spring outdoor activities become frequent as the weather becomes friendlier.…”

Section: Discussionmentioning

confidence: 99%

Trends in the seasonal variation of paediatric fractures

Segal

Slevin

Aliev

et al. 2018

Journal of Children's Orthopaedics

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PurposeThe incidence of paediatric fractures is known to peak during the summer as a consequence of unsupervised physical activity. A more sedentary lifestyle is a potential cause for changes in paediatric seasonal fracture frequency and severity. The aim of this study was to evaluate the current seasonal variations of paediatric fractures in order to determine resource allocation in hospitals, community clinics and prevention programs.MethodsA single institutional review of historical data of all patients aged 0 to 16 years that were diagnosed with fractures between April 2014 and July 2017 in the emergency department of a level 3 orthopaedic trauma centre was conducted. In all, 3484 fractures were reviewed, of which 2991 were included. We stratified fractures according to patients’ variants and the hour, day and month with respect to holidays, weekends and weather.ResultsWhile the fracture rate on school days was 6.62 per day, the fracture rate during the summer vacation was 4.45 (p < 0.01). Hot weather was correlated with low fracture rates. The peak hours of admission were 12:00 to 13:00 and 18:00 to 22:00, with more moderate differences during non-school periods.ConclusionThe local seasonal variation of paediatric fractures has a bimodal distribution, with similar nadirs during both summer and winter. These rates might reflect a shift to a more sedentary lifestyle during the summer vacation. The presented data can assist in improving the value of injury prevention measures and medical resources allocation.Level of evidence:II

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Section: Discussionmentioning

confidence: 99%

Trends in the seasonal variation of paediatric fractures

Segal

Slevin

Aliev

et al. 2018

Journal of Children's Orthopaedics

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“…Compared with the control group, the patient group showed lower bone mineral density and was more likely to be vitamin D deficient (47.1% vs. 40.8%). Likewise, Saglam et al compared the vitamin D levels of 30 fracture patients with 30 controls and found that vitamin D levels were significantly lower in patients with forearm fractures (14.5 ng/mL vs. 21.3 ng/mL, p =0.002) [ 23 ]. In contrast, Minkowitz et al failed to show a significant difference between vitamin D levels and the risk of fracture in a study that compared 369 fracture patients with 662 nonfracture controls aged 18 years and younger and find no differences in vitamin D status (27.5 ± 8.9 ng/mL vs. 27.4 ± 9.1 ng/mL) [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Vitamin D Deficiency in Children with Fractures: Before and during the COVID-19 Outbreak

Lee

Hong

et al. 2022

International Journal of Clinical Practice

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Background. Although it is generally agreed that vitamin D is important for bone health, the role of vitamin D in preventing fractures in children and adolescents remains unclear. Therefore, this study aimed to investigate the prevalence of vitamin D deficiency and insufficiency in healthy Korean children with fractures. Our secondary aim was to compare serum vitamin D levels before and during the coronavirus disease 2019 (COVID-19) outbreak. Methods. We evaluated 334 patients with fractures who were surgically treated at our institution between 2018 and 2019 before the onset of COVID-19 (group I). In addition, we collected data on the serum 25(OH)D levels of 210 patients who visited our pediatric department for evaluation of short stature (group II) and the serum 25(OH)D levels of the patients with fractures during the COVID-19 pandemic period (group III). A serum 25(OH)D level of <20 ng/mL was considered deficient, between 20 and 32 ng/mL was insufficient, and ≥32 ng/mL was considered sufficient. Results. The mean age was 8.1 ± 3.5 years in group I, 8.2 ± 3.7 years in group II, and 8.6 ± 3.5 years in group III. The prevalence of vitamin D deficiency was 53.0% in group I and 32.9% in group II. The mean serum 25(OH)D level was lower in group I than in group II (20.0 ± 7.3 ng/ml vs. 23.2 ± 6.9 ng/ml, p < 0.001 ). The mean serum 25(OH)D level of younger patients (<10 years) in group III was lower than that of the younger patients in the prepandemic period (21.4 ± 7.2 ng/mL vs. 19.2 ± 6.8 ng/mL, p = 0.037 ). Conclusions. We observed a high prevalence of vitamin D deficiency/insufficiency in children with fractures who required surgical treatment. During the COVID-19 pandemic, the serum vitamin D levels became even lower, especially in younger children.

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“…The background of repeated fractures in healthy children is insufficiently understood. Studies have shown associations between childhood fracture and higher levels of socioeconomic deprivation [ 4 ], high levels of vigorous exercise [ 5 ], high body mass index (BMI) and overweight status [ 6 ], vitamin D insufficiency [ 7 ], low calcium intakes, and physical abuse [ 8 ]. Children who fracture repeatedly may also have especially fragile skeletons, or they may be “accident-prone,” or they may occur due to sport or physical activity that actually improves bone strength during growth [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Is repeated childhood fracture related to areal bone density or body composition in middle age?

et al. 2022

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Childhood fracture is common, but whether it predicts adult fracture is not clear. Repeat childhood fracture was associated with adult (≤ 45 years) fracture, and in women, lower areal bone density was associated with repeat childhood fracture. Identifying fracture-prone children can modify adult fracture risk management. Introduction A quarter of boys and 15% of girls will suffer multiple fractures, but it is not clear whether multiple fractures during growth predict fracture risk and areal bone density in adulthood. This study evaluated whether children who repeatedly fracture were at increased risk of low areal bone density, abnormal body composition, and fractures by age 45. Methods A subsample of a large birth cohort study with childhood fracture cases had areal bone density assessed at age 45 years. Participants were questioned regularly across their lifetime about fractures during childhood (ages 0-18 years of age) and adulthood (any fracture between 18 and 45 years). The number of fractures was collapsed into three categories: no fractures; 1 fracture; and > 1 fracture, separately for child and adult groups. Results At age 45 years, areal bone mineral density (g/cm 2 ) and body composition were measured with dual X-ray absorptiometry in n = 555 participants. Compared to no fractures, twice as many girls (14% vs 7%, P = 0.156) and boys (31.4% vs 14.1%, P = 0.004) who repeatedly fractured in childhood sustained multiple fractures as adults. Both girls and boys who were fracture-free tended to remain fracture-free as adults (79.8% compared with 62.8%, P = 0.045, and 64.8% compared with 51.4%, P = 0.025, in males and females, respectively). Participants were more than twice as likely to fracture repeatedly as adults if they had sustained multiple fractures as a child (OR 2.5 95% CI: 1.4, 4.6). Women who repeatedly fractured during childhood had lower areal bone density, whereas repeated fracturing during childhood was not associated with areal bone density or body composition in men, even after adjustment for other factors known to influence fracture history. Conclusion Childhood fracture history is associated with persistent skeletal fragility in adulthood (≤ 45 years), even after adjustment for behavioral and demographic factors known to influence fracture history.

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Prevalence of vitamin D insufficiency in children with forearm fractures

Cited by 18 publications

References 30 publications

Trends in the seasonal variation of paediatric fractures

Trends in the seasonal variation of paediatric fractures

Prevalence of Vitamin D Deficiency in Children with Fractures: Before and during the COVID-19 Outbreak

Is repeated childhood fracture related to areal bone density or body composition in middle age?

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