Effects of Vitamin D Status on Forearm Fracture Healing Rates in Children and Adolescents: A Pilot Study

Summary The effect of Vitamin D deficiency on fracture healing rates in children and adolescents is currently unknown. This is a pilot study to investigate the use of pQCT in the evaluation of fracture healing rates, with or without vitamin D deficiency.

Project Details

We have validated the use of PQCT in the presence of casting applied to immobilise forearm fractures and will extend this work to evaluate fracture healing rates in this demographic. This study will be performed as a prospective observational pilot study in children and adolescents aged 8-18 years presenting to the Western Health Sunshine Hospital paediatric orthopaedic outpatients department with a forearm fracture. Eligible patients will be stratified into two groups based on their vitamin D status. Patients in both the vitamin D deficient group (less than 50 nmol/l) and the vitamin D sufficient group (greater than 75 nmol/l) will be followed and compared over 6 weeks for characterisation of fracture healing and changes in bone structure using pQCT. Those in the vitamin D deficient group will also be allocated to a randomised, placebo control trial of vitamin D treatment versus placebo. The vitamin D treatment group  will receive a bolus dose of vitamin D 170,000iu, immediately following fracture. The placebo group will be observed for the duration of the study (6 weeks) and after this will be provided with a bolus dose of vitamin D of 170,000iu.Muscle strength and cross sectional muscle area, of the unaffected arm will also be assessed at each follow up time point for all eligible patients. It is expected that the outcome of this study will provide the basis of a larger placebo controlled trial.