Association Between Serum Vitamin D Levels and Neck of Femur Fractures in the Elderly: A Cross-Sectional Observational Study.

BACKGROUND: Neck of femur fractures represent a major public health concern in the elderly, often leading to significant morbidity, mortality, and functional impairment. Vitamin D deficiency (VDD), a modifiable risk factor, is increasingly recognized for its role in bone fragility and fracture susceptibility in older adults. OBJECTIVES: The present study aimed to assess the association between serum vitamin D levels and neck of femur fractures in elderly patients and identify demographic and clinical variables influencing this relationship. METHODS: This cross-sectional observational study was conducted over 18 months at the Department of Orthopedics, Himalayan Institute of Medical Sciences, India. A total of 116 patients aged ≥60 years with radiologically confirmed neck of femur fractures were enrolled. Serum 25-hydroxyvitamin D (25(OH)D) levels were measured using enzyme-linked immunosorbent assay (ELISA) and categorized as normal, insufficient, or deficient. Data on age, gender, comorbidities, fracture type, and injury mechanism were collected and analyzed using IBM SPSS Statistics v26 (IBM Corp., Armonk, USA). RESULTS: A total of 116 elderly patients (mean age 75.32 ± 9.50 years; 66.4% women) with neck of femur fractures were enrolled. The majority (79.3%) had suboptimal vitamin D status, with 59.5% having insufficient and 19.8% having deficient levels. Only 20.7% had normal vitamin D levels. Advancing age (p = 0.003) and female gender (p = 0.002) showed significant associations with VDD. Trivial trauma, such as a slip or a fall, accounted for 87.9% of fractures, while the AO Foundation/Orthopedic Trauma Association (AO/OTA) classification revealed simple pertrochanteric (31A1) as the most frequent fracture type (46.6%). However, vitamin D status was not significantly associated with fracture classification (p = 0.573) or mode of injury (p = 0.414). CONCLUSION: VDD is highly prevalent among elderly patients presenting with neck of femur fractures, particularly in older women. Advancing age and female gender are significant predictors of this deficiency. These findings emphasize the need for routine screening and timely correction of vitamin D levels as a preventive strategy against fragility fractures in the elderly population.