TITLE:
Bone Health in Pediatric Fracture Patients: A DEXA Study
AUTHORS:
Barbara Minkowitz, Jennifer Ristic, Leah Nadel, Meghan McDermott, Violet Wallerstein, Eileen Poletick
KEYWORDS:
Bone Health, Pediatric, Fracture, Vitamin D, DEXA, Osteoporosis, Osteopenia, Vitamin D Deficiency
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.12 No.2,
February
23,
2022
ABSTRACT: Vitamin D deficiency is widespread in children and is associated with
increased fracture severity. Previous studies have shown mixed results on the
impact of vitamin D supplementation on bone
health parameters measured on dual-energy x-ray absorptiometry (DEXA) scan.
This is the first longitudinal DEXA study in a pediatric fracture population.
Pediatric fracture patients with vitamin D levels below 20
ng/mL were counseled to take vitamin D and calcium per a serum-based protocol.
Patients underwent baseline DEXA within the initial 12 weeks post fracture and
had follow-up scans at 6 and 12 months. 48 patients were enrolled, 32 patients
completed two DEXA scans, and 19 completed three DEXA scans. There was a
significant increase in lumbar spine BMC,
TBLH BMD, and TBLH BMC between DEXA 1 and 2 (p 0.001). A
positive trend in DEXA parameters is suggested between DEXA 1 and DEXA 3.
Height adjusted z-scores (HAZ) were calculated which showed no statistical significance,
p-values > 0.05. In this group, there are no significant changes in TBLH, BMC or BMD
z-scores one year after fracturing despite
vitamin D and calcium supplementation. This suggests that children returning to
collision sports may be at continued risk for refracture and future studies are
needed.