Prevalence of vitamin D deficiency and secondary hyperparathyroidism in nonunion of traumatic fractures.

Nonunion is common complication of fracture management. Various factors are involved in its occurring. Metabolic and endocrine factors are often overlooked. So that aim of study was to evaluate the level of vitamin D and PTH in patients with unexplained nonunion and fractures due to low energy trauma. In the case control study, 30 patients with tibial nonunion compared with 32 patients with normal bone healing. There were matched according to, surgical treatment, sex, age and body mass index. In order to measure the serum levels of laboratory parameters, vitamin D and parathyroid hormone, blood samples were taken and were sent to a reference laboratory. A high percentage of vitamin D deficiency was observed in tibial unexplained nonunion (60%) versus 30% in normal union. The level of vitamin D in patients with nonunion was significant difference compared with normal union (25.8±20.4 nmol/l versus 49.03±26.9 nmol/l, P=0.002). PTH measurement showed that was not meaningful statistical difference between two groups but prevalence of hyperparathyroidism in nonunion was higher than union (33% versus 9.3%). In other laboratory findings were not statistical difference. According to our results, vitamin D deficiency in unexplained tibial nonunion fractures are common. In areas with high prevalence of hypovitaminosis D, that could be one reason of unexplained nonunion.