Burns and Bones

Medical science has learned in recent years that severely burned children lose bone mass. Though their bones regenerate with time, they never achieve the same density as before the injury. For that reason, later in life many severely burned children suffer from fragile bones and risk fractures from falls. A study undertaken by UTMB pediatrics professor Gordon Klein helps explain why and proposes a possible cure.

The study, published January 24, 2004, in The Lancet, the venerable British medical journal, reported that the researchers studied skin biopsies of a dozen children treated at Galveston’s Shriners Burns Hospital. The investigators analyzed serum levels of vitamin D and bone mineral density on severely burned patients at intervals of fourteen months, two years, and seven years after the burn. Vitamin D—called the “sunshine vitamin” because normally sunlight on skin causes the body to manufacture it—was an obvious focus of study because it helps bones absorb calcium and is crucial to the development of strong bones. Doctors also know that vitamin D deficiency can lead to osteomalacia (soft bones) or, in extreme cases, rickets (soft and deformed bones). Klein and his team found to their surprise that in badly burned children, even their unburned skin can’t produce enough vitamin D to make strong bones.

Klein and colleagues propose that burned children should be given vitamin D supplements to offset their body’s diminished capacity to make vitamin D. Since the study appeared in The Lancet, the team has started supplementing all children discharged from the Shriners Acute Burn Unit with vitamin D. The team will measure their vitamin D levels and bone density one year after their burn treatment to determine whether the supplements actually work to build stronger bones.
More research is needed to tell for sure whether burned adults’ bodies are also unable to properly synthesize vitamin D from sunlight, Klein said. —Seena Simon