Prevalence of vitamin D deficiency in pediatric limb lengthening and deformity patients

Abstract

Background: Vitamin D deficiency is one of the most common vitamin deficiencies in the world, afflicting over 1-billion children. Currently, there is a shortage of studies evaluating Vitamin D levels in pediatric limb lengthening or deformity correction (LLDC) patients. The purpose of this study is to determine the prevalence of Vitamin D deficiency in pediatric patients undergoing lower extremity osteotomies for LLDC. Materials and Methods: We retrospectively analyzed pediatric patients undergoing a lower extremity long bone osteotomy for lengthening/deformity correction at a single center from 2014 to 2018. Of 214 subjects, 80% had perioperative 25-hydroxyvitamin D (25[OH]D) levels available. Variables included age, sex, race, diagnosis, long bone treated, and perioperative 25(OH) D levels. Most patients were female, Caucasian, had a congenital diagnosis, and averaged 12.7 years old. Results: A single long bone was treated in 138 subjects (80%), while 19 patients (11%) underwent ipsilateral femur and tibial surgery and 15 patients (9%) underwent a bilateral surgery. The mean 25(OH)D level was 28.7 ng/mL. Deficient levels were found in 32% of subjects, and insufficient levels were found in an additional 41%. All patients healed appropriately. Conclusions: LLDC requires optimal bone metabolism for the generation of new bone. This study revealed a high proportion of Vitamin D insufficiency in pediatric limb-lengthening patients. Identifying these patients preoperatively may allow for Vitamin D “prehabilitation” to optimize bone health before limb-lengthening procedures in order to obtain satisfactory outcomes.