Endocrine Abstracts

Introduction: Vitamin D deficiency is associated with the development of osteomalacia, as it decreases intestinal calcium absorption and bone mineralization. However, severe vitamin D deficiency may also be correlated with secondary hyperparathyroidism which induces osteoporosis. In addition, it induces muscular dysfunction which along with frailty in old age it may induce falls.

Aim: The aim was to present a group of patients with severe vitamin D deficiency who developed a hip fracture.

Methods: A group of ten old frail patients, aged 82–97 years, is presented, who developed a hip fracture. Patients were successfully operated for the hip fracture. Laboratory evaluation revealed marginally low blood calcium, low urinary calcium and very low 25(OH)D₃ levels (25(OH)D₃ <7 ng/ml, normal range >30 ng/ml).

Results: Cholecalciferol was administered to the patients initially in high dosage, thereafter in lower doses. The patients recovered fully. A period of six months after discharge from the hospital they were reevaluated. They had normal 25(OH)D₃ levels and they had recovered, physical condition found to be similar to that previous to the hip fracture.

Conclusions: In the group of patients with hip fracture presented the observed severe vitamin D deficiency contributed to the development of hip fracture, whereas the administered vitamin D acted therapeutically and contributed to the postsurgical rehabilitation of the patients. Thus, it is recommended that in old patients presenting with a hip fracture vitamin D levels should be measured and the respective vitamin D deficiency should be corrected therapeutically with the administration of cholecalciferol. In frail patients who live in closed accommodation, due to inability to get out, the measurement of vitamin D should be performed. Vitamin D administration is recommended for the prevention of falls and fractures in this group of patients.