HSS Journal

, Volume 4, Issue 2, pp 143–148

Vitamin D Deficiency: A Common Occurrence in Both High-and Low-energy Fractures


    • Hospital for Special Surgery
  • Alana Serota
    • Hospital for Special Surgery
  • David L. Helfet
    • Hospital for Special Surgery
  • Margaret Peterson
    • Hospital for Special Surgery
  • Stephen Lyman
    • Hospital for Special Surgery
  • Joseph M. Lane
    • Hospital for Special Surgery
Original Article

DOI: 10.1007/s11420-008-9083-6

Cite this article as:
Steele, B., Serota, A., Helfet, D.L. et al. HSS Jrnl (2008) 4: 143. doi:10.1007/s11420-008-9083-6


As a consequence of newly elevated standards for normal vitamin D levels, there is a renewed interest in vitamin D insufficiency and deficiency (<32 and <20 ng/ml, respectively) in the orthopedic patient population. This study tests the hypothesis that vitamin D insufficiency is comparably prevalent among both high- and low-energy fracture patients. A retrospective analysis of the medical records for 44 orthopedic trauma in-patients with non-vertebral fractures was conducted from June 1, 2006 to February 1, 2007. The obtained data included a 25-hydroxyvitamin D level, age, gender, and reason for admission; high-energy vs. low-energy fracture. Vitamin D insufficiency, 25(OH)D <32 ng/ml, was found in 59.1% of the patients. Significantly, more women (75%) than men (40%) were vitamin D insufficient among all fracture patients and specifically among high-energy fractures, 80% women insufficient vs. 25% men insufficient. In women, both high- and low-energy fractures present with vitamin D insufficiency (80% of high-energy fractures and 71.4% of low-energy fractures). In men, the mean vitamin D level was lower for low-energy fractures (16 ng/ml) compared to high-energy fractures (32 ng/ml). In addition, men with low-energy fractures were significantly older than men with high-energy fractures and women with low-energy fractures were also older. Statistically, more vitamin D insufficiency is seen in women and our results are consistent with the gender difference seen in the general population. Even among younger men who sustain a high-energy fracture, 25% are vitamin D insufficient. Women with fractures regardless of age or fracture energy level have low vitamin D levels. Levels of 25(OH)D should be measured in all orthopedic trauma patients and the American Society for Bone and Mineral Research and National Osteoporosis Foundation currently recommend that vitamin D levels should be corrected.


vitamin D25(OH)Dfracturevitamin D insufficiencyvitamin D deficiency

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© Hospital for Special Surgery 2008