Effect Of Serum 25 Hydroxy Vitamin D Level On The Healing Of Adult Limb Shaft Fracture

Objective:According to the current observation data related to vitamin D and our statistics,the rate of vitamin D deficiency and insufficiency(serum 25(OH)D level<30ng/ml)is as high as 90%in the general population.Therefore,the majority of fracture healing process is carried out under the condition of vitamin D deficiency and insufficiency.In this study,vitamin D was supplemented to patients after interal fixation of limb shaft fracture,and the serum 25(OH)D level was controlled to reach more than 30ng/ml quickly.The fracture healing of patients with sufficient vitamin D level was observed,and the effect of serum level on fracture healing was discussed.Methods:The patients with closed fractures of the extremities,whose serum is less than 30ng/ml and who need surgical internal fixation in the Department of orthopedics of Calmette Hospital Affiliated to Kunming Medical University from 2018 to 2020 were selected,and then randomly divided into the experimental group(30 cases)and the control group(30 cases),with a total of 60 cases.The experimental group was given 4800-6400IU daily vitamin D3 supplement according to the basic serum level detected on admission,so as to make the level reach the sufficient state quickly and observe the fracture healing;the control group was not given vitamin D supplement,and fracture healing was observed under the condition of insufficient and deficient serum 25(OH)D level.The serum level,Lane-Sandhu score,clinical healing time,nonunion rate,delayed healing rate and bone healing time of the two groups were compared.Results:After 45 days of internal fixation operation,the average level of serum 25(OH)D level in the experimental group was more than 40ng/ml.With the extension of time,the serum 25(OH)D level also increased,reaching about 70ng/ml at 12 months after operation.The serum 25(OH)D level of all cases in the control group were lower than 30 ng/ml at all stages of follow-up.The serum 25(OH)D level in the experimental group were significantly higer than those in.the control group at 45days,3 months,6 months,6 months,9 months and 12 months after operation(P<0.05).Lane-Sandhu scores of 45days,3 months,6 months,6 months,9 months and 12 months after operation in the experimental group were significantly higer than those in the control group(P<0.05).The delayed union rate and nonunion rate of the experimental group were lower than those of the control group(P<0.05).The clinical healing time and bone healing time of the experimental group were shorter than those of the control group(P<0.05).In the experimental group,no hypercalcemia and no adverse reactions occurred after vitamin D3 supplementation.Conclusions:Compared with vitamin D deficiency and insufficiency,fracture healing with adequate vitamin D level has lower incidence of negative results,higher quality of fracture healing,and can significantly shorten the fracture healing time.Therefore,it is more conducive to fracture healing for fracture patient to supplement vitamin D quickly and make vitamin D level sufficient and fracture healing is more healthy.In the fracture population,the daily dose of 4800-5600IU vitamin D3 can quickly make the serum 25(OH)D level reach an adequate state,and with the extension of time,the level becomes higher and higher.The daily dose of 4800-5600IU vitamin D3 is safe and effective,and there is no adverse reaction of vitamin D.