Vitamin K therapy for cortical bone fragility caused by reduced mechanical loading in a child with hemiplegia.
J Musculoskelet Neuronal Interact
; 7(3): 219-23, 2007.
Article
em En
| MEDLINE
| ID: mdl-17947803
ABSTRACT
Fractures frequently occur at cortical bone sites in children with cerebral palsy, but there is no established therapy. We previously found that treatment with vitamins D and K increased cortical bone mass in children with severe physical disability, and have hypothesized that vitamin K could play a significant role in pediatric cortical bones under conditions with reduced mechanical loading. In the present case report, we treated a right hemiplegic ambulant eight-year-old boy with oral vitamin K (15 mg per day) for eight months. Cortical bone geometries at mid-diaphyseal sites in bilateral tibiae were evaluated before and after the treatment. The cross-sectional total, bone and marrow areas of non-hemiplegic tibia increased by 8.8%, 7.4% and 12.0%, respectively, while those of hemiplegic tibia changed by 9.0%, 14.9% and -3.4%, respectively. As a result, the polar moment of inertia, an indicator of the resistance to torsion forces, increased by 13.0% in the non-hemiplegic tibia and by 63.7% in the hemiplegic tibia. Vitamin K may restrict cortical bone fragility, caused by reduced mechanical loading, through its actions at the endosteal bone marrow interface. Further studies are needed to confirm these findings and to clarify the mechanisms involved.
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Base de dados:
MEDLINE
Assunto principal:
Osteoporose
/
Tíbia
/
Vitamina K
/
Hemiplegia
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
Limite:
Child
/
Humans
/
Male
Idioma:
En
Revista:
J Musculoskelet Neuronal Interact
Assunto da revista:
FISIOLOGIA
/
NEUROLOGIA
/
ORTOPEDIA
Ano de publicação:
2007
Tipo de documento:
Article
País de afiliação:
Japão