Vitamin D and Metabolic Supplementation in Orthopedic Trauma

Nino, Samantha; Soin, Sandeep; Avilucea, Frank R.

doi:10.1016/j.ocl.2018.12.001

Cited by 10 publications

(8 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Ultimately, our findings confirm evidence about the pervasive vitamin D inadequacy among oldest-old people, by showing that 90.5% of participants had low 25(OH)D serum levels [1,35,36], despite being physically and cognitively preserved before hospitalization. About 37% of participants had vitamin D-insufficiency with secondary hyper-parathyroidism with calcium, phosphorus and creatinine levels in the normal range.…”

Section: Discussionsupporting

confidence: 77%

“…Low serum levels of vitamin D are pervasive in older people, especially among those with fragility fractures [1]. Falls and fractures are causally related to low serum 25-hydroxyvitamin D [25(OH)D], leading to decreased intestinal calcium absorption, increased intact parathyroid hormone (iPTH) secretion and bone resorption, impaired muscle function and bone strength.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of Weekly Supplementation of Cholecalciferol and Calcifediol Among the Oldest-Old People: Findings From a Randomized Pragmatic Clinical Trial

et al. 2019

View full text Add to dashboard Cite

Vitamin D inadequacy is pervasive in the oldest-old. Many vitamin D metabolites are available for supplementation, their effects on the recovery of adequate serum levels remain unknown. We investigate the effects of supplementation with cholecalciferol (D3) and calcifediol (25D3) on serum levels of 25(OH)D, 1-25(OH)D, bone and inflammatory markers, ultimately identifying clinical predictors of successful treatment. Sixty-seven oldest-old individuals were randomized to weekly administration of 150 mcg of 25D3 or D3, from hospital admission to 7 months after discharge. Supplementation of 25D3 and D3 were associated with increasing serum levels of 25(OH)D (p < 0.001) and 1-25(OH)D (p = 0.01). Participants on 25D3 experienced a steeper rise than those on D3 (group*time interaction p = 0.01), after adjustment for intact parathyroid hormone (iPTH) levels the differences disappeared (intervention*iPTH interaction p = 0.04). Vitamin D supplementation was associated with a decreasing trend of iPTH and C-reactive protein (CRP) (p < 0.001). Polypharmacy and low handgrip strength were predictors of failure of intervention, independent of vitamin D metabolites. In conclusion, D3 and 25D3 supplementation significantly increase vitamin D serum levels in the oldest-old individuals, with a tendency of 25D3 to show a faster recovery of acceptable iPTH levels than D3. Polypharmacy and low muscle strength weaken the recovery of adequate vitamin D serum levels.

show abstract

Section: Discussionsupporting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Effects of Weekly Supplementation of Cholecalciferol and Calcifediol Among the Oldest-Old People: Findings From a Randomized Pragmatic Clinical Trial

et al. 2019

View full text Add to dashboard Cite

show abstract

“…26 O cirurgião ortopédico deve estar preparado para reconhecer a HVD e saber rastreá-la e tratá-la, ou encaminhar o paciente. 27 Na prática diária, os pacientes internados com fraturas para se submeter ao tratamento cirúrgico realizam exames pré-operatórios que habitualmente não envolvem a dosagem da VIT D. Dada a importância da VIT D na força muscular e no equilíbrio, e seu papel (ainda que questionável) na consolidação das fraturas, sugere-se que, quando possível, a dosagem de VIT D (exame relativamente caro e não coberto pelo SUS) faça parte da rotina pré-operatória, em especial nos idosos ou mulheres na pós-menopausa com fraturas, bem como seja feita a sua reposição, caso necessário. A HV D está presente em todas as faixas etárias e grupos populacionais, em especial entre os idosos brasileiros, que dependem da síntese cutânea para obter suficiência.…”

Section: Discussionunclassified

Influência da hipovitaminose D na ocorrência das fraturas

Valle

Pedri

Pires

et al. 2021

Rev Bras Ortop (Sao Paulo)

View full text Add to dashboard Cite

Resumo Objetivo Dosar a vitamina D nos pacientes internados por fratura e avaliar sua relação com as fraturas. Métodos Realizou-se estudo primário, analítico, transversal, não intervencional, observacional, controlado, em seres humanos. Fez-se a dosagem sérica de: vitamina D, paratormônio(PTH), cálcio, fósforo, magnésio e albumina em 49 pacientes que foram internados consecutivamente para cirurgia devido a fratura(s) (grupo de estudo), e em 50 pacientes, dos diversos ambulatórios, sem fraturas, e que realizaram exames de rotina (grupo de controle). Resultados A média de 25-hidroxivitamina D (25[OH]D) nos pacientes com fraturas foi de 23,78 ± 8,01 ng/mL (61,22% dos pacientes com fraturas apresentaram hipovitaminose D). A média de 25(OH)D do grupo de controle foi de 37,52 ± 9,21 ng/mL (10% dos pacientes apresentaram hipovitaminose D). A maioria dos casos de hipovitaminose (96%) não cursou com hiperparatireoidismo secundário (média do PTH = 41,80 ± 22,75 pg/mL). Conclusão A hipovitaminose D foi encontrada em um percentual expressivo (61,22%) dos pacientes que sofreram fraturas. Mais estudos sobre o assunto são necessários para se compreender melhor a influência da hipovitaminose D na ocorrência das fraturas e os benefícios da suplementação com vitamina D nesses pacientes.

show abstract

“…Hypertrophic nonunions typically require eradication of infection and biomechanical optimization of the fracture fixation [18] . Atrophic nonunions typically lack "biology" and may need systemic metabolic/endocrinologic optimization [19] , increase in blood supply with the use of flaps [20] , and the addition of osteobiologics with osteoinductive and osteogenic properties. Examples include nonunions of the clavicle [21] , tibia [22] , and distal femur [22] .…”

Section: The Whenmentioning

confidence: 99%

Use of Osteobiologics for Fracture Management: The When, What, and How

Marmor

Matz

McClellan

et al. 2021

Injury

View full text Add to dashboard Cite

Osteobiologics are defined as a group of natural and synthetic materials used to augment bone healing. The selection of the most appropriate osteobiologic from the growing list of available options can be a challenging task. In selecting a material, surgeons should weigh a variety of considerations, including the indication for their use (the when), the most suitable substance (the what), and the correct mode of application (the how). This summary reviews these considerations and seeks to provide the surgeon with a basis for informed clinical evidence-based decision-making in their choice of a successful option.

show abstract

Vitamin D and Metabolic Supplementation in Orthopedic Trauma

Cited by 10 publications

References 38 publications

Effects of Weekly Supplementation of Cholecalciferol and Calcifediol Among the Oldest-Old People: Findings From a Randomized Pragmatic Clinical Trial

Effects of Weekly Supplementation of Cholecalciferol and Calcifediol Among the Oldest-Old People: Findings From a Randomized Pragmatic Clinical Trial

Influência da hipovitaminose D na ocorrência das fraturas

Use of Osteobiologics for Fracture Management: The When, What, and How

Contact Info

Product

Resources

About