Prevalence of Vitamin D Deficiency in Patients Presenting with an Orthopaedic Trauma at a Tertiary Centre in South India - Implications and Protocols for Replacement Therapy

Vitamin D has been the focus of much scientific literature in recent years owing to various studies showing its association with a wide variety of pathological conditions . Sun exposure, diet and fortified supplementation account for a bulk of Vitamin D intake in humans. Activation of vitamin D is sequential and requires sun exposure for conversion of 7dehydrocholesterol to Vitamin D3. Further metabolism in the liver converts Vitamin D3 to 25 –hydroxyvitamin D3. Conversion to its active form 1,25 dihydroxyvitamin D3 (Calcitriol) occurs in the kidneys . The importance of Vitamin D in calcium metabolism and bone health is well known and documented. Controversies exist regarding the true prevalence of hypovitaminosis, however in developing countries the prevalence of vitamin D deficiency in all age groups is probably higher . Adding to this the burden and morbidity of skeletal trauma, persistent deficiency may have a deleterious effect in the injured 4, . Vitamin D, with its positive effect on bone health does play a role in the biology of fracture repair and remodelling . The role of Vitamin D replacement as sole biological effectors in fracture repair may be difficult to quantify and confounded by other variables at play in bone healing. Studies looking at vitamin D levels in orthopaedic patients have also shown significant levels of deficiency and have put forward recommendations for evaluation and supplementation .