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Vitamin D Deficiency in Hip Fracture Patients: Outcome-Specific Associations and Post-Fracture Management-A Narrative Review

Lee H, Lee J, Lee Y, Song SK

Medicina (Kaunas, Lithuania), 2026

Abstract

Background and Objectives: Vitamin D deficiency is common in older adults with hip fracture and has been associated with adverse postoperative outcomes. However, heterogeneity in deficiency thresholds, outcome definitions, and patient populations has complicated the interpretation and clinical application of existing evidence. This narrative review aimed to summarize current evidence regarding perioperative vitamin D status, its associations with postoperative complications, mortality, functional recovery, and secondary fracture, and the role of vitamin D supplementation after hip fracture. Materials and Methods: Relevant studies were identified through PubMed searches and manual screening of reference lists. Cohort studies, randomized controlled trials, systematic reviews, meta-analyses, and clinical guidelines addressing vitamin D status, supplementation, hip fracture outcomes, fracture prevention, or postoperative recovery in older adults were narratively synthesized. Results: Low serum 25-hydroxyvitamin D was associated with selected early medical complications, mortality, impaired functional recovery, and secondary hip fracture, although these associations varied across outcomes. The strongest prognostic associations with mobility were observed in patients with severe deficiency (approximately ≤10-12 ng/mL), whereas mild insufficiency showed less consistent associations. Heterogeneity among studies reflected differences in deficiency thresholds, sampling timing, outcome…

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