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British Army recruits with low serum vitamin D take longer to recover from stress fractures
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  1. Thomas Richards1 and
  2. C Wright1,2
  1. 1 Imperial College Healthcare NHS Trust, St Mary’s Hospital, Praed Street, London, UK
  2. 2 Defence Medical Services, Medical Directorate, Royal Centre for Defence Medicine, Birmingham, England
  1. Correspondence to Dr Thomas Richards, Imperial College Healthcare NHS Trust, St Mary’s Hospital, Praed Street, London, UK; tjrichards{at}doctors.org.uk

Abstract

Background Recruits undergoing military training experience a particularly high incidence of stress fractures. The role of combined calcium and vitamin D (25-OHD) deficiency and subsequent supplementation has been well described in the literature, but the role of 25-OHD deficiency alone is less well understood, particularly its influence on recovery once a stress fracture has been incurred.

Methods Retrospective data of recruits who had incurred stress fractures were collected (n=37). Independent-samples t-tests were conducted in Microsoft Excel to investigate the association between serum-25 OHD and the time taken to recover.

Results Significant differences (p<0.05) were found in the mean time taken to recover from stress fractures when participants were grouped according to serum 25-OHD level. Sufficient levels of serum 25-OHD (>50 nmol/L) at the time of injury resulted in shorter recovery times than all other groups.

Conclusion The study demonstrated an association between serum 25-OHD level and the time taken to recover from a stress fracture. The sample population of this study was too small to contribute to the discussion about whether a minimum serum 25-OHD status should be met before entering British Army training, but a larger prospective study should be able to provide the data required for a cost benefit analysis to be conducted and a decision made.

  • rheumatology
  • calcium & bone
  • adult orthopaedics
  • foot & ankle
  • heumatology

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Footnotes

  • Collaborators Hem Goshai Vicky Laws Amit Amin.

  • Contributors TR conceived, undertook and wrote the article. CW gave advice during writing and edited the final draft.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Ethics approval St George's Hospital Medical School.

  • Provenance and peer review Not commissioned; externally peer reviewed.