The role of vitamin D in general health maintenance is a topic of increasing interest and importance in the medical community. Various authors have demonstrated a correlation between vitamin D deficiency and muscle weakness, fragility fractures and fracture nonunion. Documenting the prevalence of vitamin D deficiency in orthopaedic trauma patients is of vital importance as a first step in raising awareness among orthopaedic traumatologists and further determining a screening and treatment strategy for vitamin D deficiency in the trauma patient population. The purpose of this study was to determine the prevalence of vitamin D deficiency or insufficiency in orthopaedic trauma patients at a level 1 trauma center.

A retrospective medical record review was done of all orthopaedic trauma patients above the age of 18 managed at a university level 1 trauma center from January 1, 2009 to September 30, 2010 to identify patients that had a documented 25-hydroxyvitamin D level. Vitamin D deficiency was defined as a 25-hydroxyvitamin D level of less than 20 ng/ml and insufficiency was defined as a level between 20 and 32 ng/ml.

A total of 889 of 1,830 patients were identified that had a 25-hydroxyvitamin D level. Vitamin D deficiency had an overall prevalence of 39%. However, combined deficiency and insufficiency had an overall prevalence of 77.4%. Overall, 18-25 year olds had the lowest prevalence of deficiency at 29.1% (p=0.25) and insufficiency at 54.7% (p=0.08). The 36-55 year olds had higher prevalence of deficiency and insufficiency but neither were statistically significant. Females ages 18-25 had lower prevalence of deficiency (25%, p=0.41) and insufficiency (41.7%, p=0.16) than other females. Males age 18-25 had a lower prevalence of insufficiency (59.7%, p=0.24) than other males. Otherwise, no remarkable differences were detected in prevalence of deficiency or insufficiency based on age or sex.

Both vitamin D deficiency and insufficiency was prevalent in this large population of orthopaedic trauma patients. To our knowledge, this is the largest patient population of orthopaedic trauma patients to be evaluated for vitamin D deficiency. In addition, our study time frame of 21 months helps to account for seasonal variation in the prevalence of vitamin D deficiency. Establishing the incidence of vitamin D deficiency in a trauma population is of significant importance to raise awareness of the disease, and change screening and treatment patterns.