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Published in: HSS Journal ® 1/2013

01-02-2013 | Original Article

Plasma 25-Hydroxyvitamin D Levels in Operative Patella Fractures

Authors: Keith R. Reinhardt, MD, Lionel E. Lazaro, MD, Ben-Paul Umunna, BA, Michael B. Cross, MD, David L. Helfet, MD, Joseph M. Lane, MD, Dean G. Lorich, MD

Published in: HSS Journal ® | Issue 1/2013

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Abstract

Background

Patella fractures have not traditionally been considered “fragility” fractures.

Questions/Purpose

The purpose of this study was to examine the demographic patterns (age and gender distribution) and plasma 25-hydroxyvitamin D levels of a cohort of patients with operative patella fractures.

Patients and Methods

Medical records were reviewed on all consecutive patients presenting to our institution with operative patella fractures from 2003 to 2009. Seventy-eight operative patella fractures (25 male, 53 female) were identified with a mean age of 58 years (range, 22–89 years).

Results

The majority of patients with patella fractures in this series were females over the age of 50 years who sustained low-energy falls from a standing height or less. Twenty-four patients (80%) had vitamin D insufficiency or deficiency at the time of injury. For 68 patients (87%), the patella fracture represented their first fracture. Patients with known osteoporosis risk factors did not have higher rates of vitamin D insufficiency/deficiency.

Conclusions

The age and gender distribution, as well as the prevalence of vitamin D insufficiency/deficiency, of operative patella fractures, suggest that these patients likely have abnormal vitamin D levels and should undergo a metabolic bone work-up.
Literature
1.
go back to reference Borgstrom F, Zethraeus N, Johnell O, et al. Costs and quality of life associated with osteoporosis-related fractures in Sweden. Osteoporos Int. 2006;17(5):637–650.PubMedCrossRef Borgstrom F, Zethraeus N, Johnell O, et al. Costs and quality of life associated with osteoporosis-related fractures in Sweden. Osteoporos Int. 2006;17(5):637–650.PubMedCrossRef
2.
go back to reference Brinker MR, O’Connor DP, Monla YT, et al. Metabolic and endocrine abnormalities in patients with nonunions. J Orthop Trauma. 2007;21(8):557–570.PubMedCrossRef Brinker MR, O’Connor DP, Monla YT, et al. Metabolic and endocrine abnormalities in patients with nonunions. J Orthop Trauma. 2007;21(8):557–570.PubMedCrossRef
3.
go back to reference Bukata SV, Kates SL, O’Keefe RJ. Short-term and long-term orthopaedic issues in patients with fragility fractures. Clin Orthop Relat Res. 2011;469(8):2225–2236.PubMedCrossRef Bukata SV, Kates SL, O’Keefe RJ. Short-term and long-term orthopaedic issues in patients with fragility fractures. Clin Orthop Relat Res. 2011;469(8):2225–2236.PubMedCrossRef
4.
go back to reference Collinge C, LeBus G, Gardner MJ, et al. Osteoporosis in orthopaedic trauma patients: a diagnosis and treatment protocol. J Orthop Trauma. 2008;22(8):541–547. discussion 548–9.PubMedCrossRef Collinge C, LeBus G, Gardner MJ, et al. Osteoporosis in orthopaedic trauma patients: a diagnosis and treatment protocol. J Orthop Trauma. 2008;22(8):541–547. discussion 548–9.PubMedCrossRef
5.
go back to reference Dawson-Hughes B, Mithal A, Bonjour JP, et al. IOF position statement: vitamin D recommendations for older adults. Osteoporos Int. 2010;21(7):1151–1154.PubMedCrossRef Dawson-Hughes B, Mithal A, Bonjour JP, et al. IOF position statement: vitamin D recommendations for older adults. Osteoporos Int. 2010;21(7):1151–1154.PubMedCrossRef
6.
go back to reference Eknoyan G. Adolphe Quetelet (1796–1874)—the average man and indices of obesity. Nephrol Dial Transplant. 2008;23(1):47–51.PubMedCrossRef Eknoyan G. Adolphe Quetelet (1796–1874)—the average man and indices of obesity. Nephrol Dial Transplant. 2008;23(1):47–51.PubMedCrossRef
7.
go back to reference Gass M, Dawson-Hughes B. Preventing osteoporosis-related fractures: an overview. Am J Med. 2006;119(4 Suppl 1):S3–S11.PubMedCrossRef Gass M, Dawson-Hughes B. Preventing osteoporosis-related fractures: an overview. Am J Med. 2006;119(4 Suppl 1):S3–S11.PubMedCrossRef
8.
go back to reference Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int. 2006;17(12):1726–1733.PubMedCrossRef Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int. 2006;17(12):1726–1733.PubMedCrossRef
9.
go back to reference Kanis JA. Diagnosis of osteoporosis and assessment of fracture risk. Lancet. 2002;359(9321):1929–1936.PubMedCrossRef Kanis JA. Diagnosis of osteoporosis and assessment of fracture risk. Lancet. 2002;359(9321):1929–1936.PubMedCrossRef
10.
go back to reference Kanis JA, Oden A, Johnell O, et al. The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int. 2001;12(5):417–427.PubMedCrossRef Kanis JA, Oden A, Johnell O, et al. The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int. 2001;12(5):417–427.PubMedCrossRef
11.
go back to reference Leboff MS, Kohlmeier L, Hurwitz S, et al. Occult vitamin D deficiency in postmenopausal US women with acute hip fracture. JAMA. 1999;281(16):1505–1511.PubMedCrossRef Leboff MS, Kohlmeier L, Hurwitz S, et al. Occult vitamin D deficiency in postmenopausal US women with acute hip fracture. JAMA. 1999;281(16):1505–1511.PubMedCrossRef
12.
go back to reference Melhus H, Snellman G, Gedeborg R, et al. Plasma 25-hydroxyvitamin D levels and fracture risk in a community-based cohort of elderly men in Sweden. J Clin Endocrinol Metab. 2010;95(6):2637–2645.PubMedCrossRef Melhus H, Snellman G, Gedeborg R, et al. Plasma 25-hydroxyvitamin D levels and fracture risk in a community-based cohort of elderly men in Sweden. J Clin Endocrinol Metab. 2010;95(6):2637–2645.PubMedCrossRef
13.
go back to reference Meunier P. Prevention of hip fractures by correcting calcium and vitamin D insufficiencies in elderly people. Scand J Rheumatol Suppl. 1996;103:75–78. discussion 79–80.PubMedCrossRef Meunier P. Prevention of hip fractures by correcting calcium and vitamin D insufficiencies in elderly people. Scand J Rheumatol Suppl. 1996;103:75–78. discussion 79–80.PubMedCrossRef
14.
go back to reference NIH Consensus. Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA. 2001;285(6):785–795.CrossRef NIH Consensus. Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA. 2001;285(6):785–795.CrossRef
15.
go back to reference Nuti R, Martini G, Valenti R, et al. Vitamin D status and bone turnover in women with acute hip fracture. Clin Orthop Relat Res. 2004;422:208–213.PubMedCrossRef Nuti R, Martini G, Valenti R, et al. Vitamin D status and bone turnover in women with acute hip fracture. Clin Orthop Relat Res. 2004;422:208–213.PubMedCrossRef
16.
go back to reference Oyen J, Brudvik C, Gjesdal CG, et al. Osteoporosis as a risk factor for distal radial fractures: a case–control study. J Bone Joint Surg Am. 2011;93(4):348–356.PubMedCrossRef Oyen J, Brudvik C, Gjesdal CG, et al. Osteoporosis as a risk factor for distal radial fractures: a case–control study. J Bone Joint Surg Am. 2011;93(4):348–356.PubMedCrossRef
17.
go back to reference Sontag A, Krege JH. First fractures among postmenopausal women with osteoporosis. J Bone Miner Metab. 2010;28(4):485–488.PubMedCrossRef Sontag A, Krege JH. First fractures among postmenopausal women with osteoporosis. J Bone Miner Metab. 2010;28(4):485–488.PubMedCrossRef
18.
go back to reference Stegman MR, Davies KM, Heaney RP, et al. The association of patellar ultrasound transmissions and forearm densitometry with vertebral fracture, number and severity: the Saunders County Bone Quality Study. Osteoporos Int. 1996;6(2):130–135.PubMedCrossRef Stegman MR, Davies KM, Heaney RP, et al. The association of patellar ultrasound transmissions and forearm densitometry with vertebral fracture, number and severity: the Saunders County Bone Quality Study. Osteoporos Int. 1996;6(2):130–135.PubMedCrossRef
19.
go back to reference Van Schoor NM, Visser M, Pluijm SM, et al. Vitamin D deficiency as a risk factor for osteoporotic fractures. Bone. 2008;42(2):260–266.PubMedCrossRef Van Schoor NM, Visser M, Pluijm SM, et al. Vitamin D deficiency as a risk factor for osteoporotic fractures. Bone. 2008;42(2):260–266.PubMedCrossRef
20.
go back to reference World Health Organization. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. 1994. World Health Organization. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. 1994.
Metadata
Title
Plasma 25-Hydroxyvitamin D Levels in Operative Patella Fractures
Authors
Keith R. Reinhardt, MD
Lionel E. Lazaro, MD
Ben-Paul Umunna, BA
Michael B. Cross, MD
David L. Helfet, MD
Joseph M. Lane, MD
Dean G. Lorich, MD
Publication date
01-02-2013
Publisher
Springer-Verlag
Published in
HSS Journal ® / Issue 1/2013
Print ISSN: 1556-3316
Electronic ISSN: 1556-3324
DOI
https://doi.org/10.1007/s11420-012-9324-6

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