PTCase ReportJournal of physical therapy science2017

Nonhealing, progressive stress fractures of the foot in a 13-year-old basketball player: is vitamin K deficiency a risk factor?

Meral Bayramoğlu, Nuray Ünlütürk

PMID 28533626

WHAT IT FOUND

A 13-year-old basketball player had foot bone edema that progressed despite initial immobilization and physiotherapy.

Vitamin K was low, but no follow-up level was checked, and return to sport at 6 months cannot be credited to diet.

Key findings

01A 13-year-old basketball player had foot pain and MRI bone edema that progressed despite initial treatment.

02Serum vitamin K was below normal range, but the authors state this case cannot be directly related to vitamin K deficiency alone and no follow-up level was performed.

03The patient returned to full sport activities at the 6th month, which the authors note is approximate expected time for many stress fractures.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

This is a single case report, so it cannot show that any treatment worked or that vitamin K deficiency caused the problem. The authors state the case cannot be directly related to vitamin K deficiency alone. No follow-up serum vitamin K level was measured after dietary advice. The previous vitamin K deficiency history was parent-reported, and the old test result was unavailable. Diet was described by parents, and an exact food diary could not be obtained. Return to sport at 6 months is described as approximate expected time for many stress fractures. Serum vitamin K level is not routinely checked and was ordered only because of a nonspecific history.

The easy way to misread this

Do not conclude that vitamin K deficiency caused the nonhealing fractures or that green vegetables healed them. The authors state the case cannot be directly related to vitamin K deficiency alone, no follow-up vitamin K level was performed, and return to sport at 6 months is approximate expected time for many stress fractures.

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