The effect of vitamin D on the speed and quality of pediatric fracture healing

Purpose: To evaluate the effect of vitamin D on the speed and quality of pediatric fracture healing.Methods: 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.Results: 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.Conclusions: Based on our results, we recommend vitamin D testing and administration for children treated for forearm and femoral fractures.Level of evidence: Level I.