Assessment of Vitamin D Levels and Its Correlation With Osteoporosis and Fracture Site Comminution in Osteoporotic Hip Fractures in Tertiary Care Hospital

Abstract

Introduction: A global concern is vitamin D deficiency and insufficiency. There is a particularly high risk for pregnant women, people of color (Blacks, Hispanics, and those with increased skin melanin pigmentation), obese children and adults, and children and adults who are abstinent from direct sun exposure. The goal of this study was to understand the incidence of vitamin D deficiency in patients with osteoporotic hip fractures in our rural population and also to know its association with osteoporosis and osteoporotic hip fractures in a tertiary care trauma center. Methods: This prospective research was performed at our tertiary trauma treatment center in Kolar, Karnataka, India by the Department of Orthopedics from September 2019 and July 2020. The age category was 45-90 years, intertrochanteric fractures were graded using the Boyd and Griffin classification and femoral neck fractures the Garden's staging. The research included all patients with fractures after a trivial trauma such as slip and fall while standing/walking and excluded patients with a serious history of trauma such as road traffic accidents/falls from height and pathological fractures. This study involved 30 patients. Age and gender, type of fracture, vitamin D levels, Singh’s index, and comminution of fracture site were reported in patient demographics. Results: Thirty patients comprised the study population. Most of them were female. Females comprised 18 out of the 30. There were twelve, thirteen, and five persons in our sample population between the ages of 45-60, 61-75, and >75 years. The Singh's index was tabulated. Mean vitamin D levels were 9.64+/-3.23 in the femur fracture group and 13.42+/-5.31 in the intertrochanteric fracture group. Mean levels of vitamin D are included as a graphical representation. The comminution of the fracture site in groups of the femur and intertrochanteric fractures was eight and six, respectively. Conclusion: Early diagnosis and treatment of these patients with vitamin D for osteomalacia and anti-osteoporotic osteoporosis regimens will hopefully enhance bone, muscle, and general health, minimizing falls and fractures.

Influence of comorbidity on postoperative course and mortality in patients with hip fracture

“…A large number of papers have been published in the world literature which try to find the factors that influence the prognosis of hip fractures, both in the physical recovery of the patient and in their survival [1,3,7,9]. Knowing the predictors of mortality is very useful because of the treatment plan for each patient individually, and in that way, the risk of death would be reduced [4,6,8].…”

“…The mental status of a person who has suffered a hip fracture plays a significant role in the choice of treatment method and the final result of [17,20]. Some studies show a persistently increased mortality of [5,21], while others suggest either no long-term increased mortality [7,17] or only moderately increased long-term mortality compared to that expected in the elderly [3,6,22]. many studies, mortality appears to be attributed to the hip fracture itself, ignoring the fact that these are patients with an already increased risk of death from other causes [18,21,23].…”

“…Hip fractures present one of the biggest medical, social, and financial problems in the world, especially in the developed countries of the West. About 20% of all hospitalized orthopedic-traumatological patients are patients with hip fractures [1,2,3]. The number of hip fractures increases exponentially with age.…”

“…As one of the complications of osteoporosis, both due to its high incidence and due to the associated morbidity and mortality, hip fractures represent a significant problem in health, social, economic, and family terms [1,5]. The basic precondition for the elderly to achieve "optimal physiological condition" to be able to perform the planned operation is the cooperative teamwork of orthopedists, anesthesiologists, and internists [3,6]. All hip fractures are divided into: intracapsular (femoral neck fractures) and extracapsular (intertrochanteric and subtrochanteric fractures).…”

“…The method of choice for patients with hip fractures is surgical treatment. In intra-articular fractures, hemiarthroplasty or total arthroplasty is used, and in extracapsular fractures, open repositioning and internal fixation of fractures are used [3,4,7]. Non-operative treatment is applied only in patients in whom the general condition is so bad that the risk of surgery is greater than the advantage of early fixation.…”