Hendrych Jan, Havránek Petr, Bayer Milan, Čepelík Martin, Pešl Tomáš
Third Faculty of Medicine, Department of Pediatric and Trauma Surgery, Charles University, Thomayer Teaching Hospital, Prague, Czech Republic.
Third Faculty of Medicine, Department of Children and Adolescents, Charles University, University Hospital Královské Vinohrady, Prague, Czech Republic.
J Child Orthop. 2024 Nov 16;19(1):29-47. doi: 10.1177/18632521241299624. eCollection 2025 Feb.
To evaluate the effect of vitamin D on the speed and quality of pediatric fracture healing.
A 4-year prospective study of healthy children with shaft fractures of the forearm bones (treated with minimally invasive osteosynthesis) or femur (treated by traction or by minimally invasive osteosynthesis). All children had their vitamin D levels examined four times-at the time of the injury, 1, 3, and 5 months after the injury. Also, all children underwent radiograph follow-ups (same time as blood tests) to evaluate fracture healing. Children were, in the beginning, blindly divided into two similarly sized groups-one group was orally administered cholecalciferol throughout the follow-up, the second group was not, and we compared those groups.
Altogether, 63 children were included in the study-36 supplemented and 27 non-supplemented. In supplemented children, the vitamin D levels increased statistically significantly during the follow-up period, in contrast to the non-supplemented group. The fracture healing on radiographs was also statistically significantly faster and better in the supplemented group. When we divided children according to fracture type, we observed statistically significantly better fracture healing in children with forearm fractures in the supplemented group for the whole study period. In children with femoral fractures, the healing in the supplemented group was statistically significantly better after 3 months; however, after 1 and 5 months, the difference was not statistically significant.
Based on our results, we recommend vitamin D testing and administration for children treated for forearm and femoral fractures.
Level I.
评估维生素D对小儿骨折愈合速度和质量的影响。
对健康的前臂骨干骨折（采用微创接骨术治疗）或股骨骨折（采用牵引或微创接骨术治疗）儿童进行为期4年的前瞻性研究。所有儿童在受伤时、受伤后1、3和5个月检测4次维生素D水平。此外，所有儿童均接受X线片随访（与血液检测时间相同）以评估骨折愈合情况。开始时，将儿童随机分为两组，每组人数相近——一组在整个随访期间口服胆钙化醇，另一组不服用，然后对两组进行比较。
共有63名儿童纳入研究，其中36名补充维生素D，27名未补充。与未补充组相比，补充组儿童在随访期间维生素D水平有显著统计学意义的升高。补充组X线片显示的骨折愈合在统计学上也显著更快、更好。当我们根据骨折类型对儿童进行分组时，在整个研究期间，补充组前臂骨折儿童的骨折愈合在统计学上明显更好。对于股骨骨折儿童，补充组在3个月后的愈合情况在统计学上明显更好；然而，在1个月和5个月时，差异无统计学意义。
根据我们的研究结果，我们建议对接受前臂和股骨骨折治疗的儿童进行维生素D检测和补充。
I级。
