To explore the regulatory effect of vitamin D pulse therapy on bone metabolism markers and bone mineral density in critical patients of chronic osteomyelitis after trauma.

A retrospective analysis was conducted on 80 critically ill patients with post-traumatic chronic osteomyelitis admitted to the Third People's Hospital of Yangzhou City from June 1, 2021 to May 2024. This study used a case-control study sampling, with 46 males and 34 females; The age ranged from 35 to 66 years old, with an average of (52.95±2.61) years. According to the treatment method, the patients were divided into an observation group and a control group, with 40 cases in each group. The control group received antibacterial treatments such as benzylpenicillin and clindamycin, while the observation group received vitamin D shock therapy in addition to the control group. Both groups were treated for 6 months. Compare the recovery status of two groups, including bone metabolism markers [osteocalcin (OC), type I collagen carboxy terminal peptide (CTX-I)], bone density, white blood cell count (WBC), and erythrocyte sedimentation rate (ESR) after 3 months and 6 months of treatment, and compare the incidence of adverse reactions during treatment.

Compared with the baseline before treatment, the levels of OC significantly increased and CTX-I levels significantly decreased at 3 and 6 months after treatment in both patient groups, with statistically significant differences (P<0.05); compared with 3 months of treatment in the same group, OC levels further increased and CTX-I levels further decreased at 6 months after treatment in both patient groups, and the differences were statistically significant (P<0.05). At 3 months after treatment, the observation group had higher OC level and lower CTX-I level than the control group (P<0.05); at 6 months after treatment, the observation group still showed higher OC level and lower CTX-I level relative to the control group, with statistically significant differences (P<0.05). The bone mineral density of both groups was significantly elevated at 3 and 6 months after treatment compared with the baseline before treatment (P<0.05), and the bone mineral density at 6 months after treatment was higher than that at 3 months after treatment in the same group (P<0.05); the observation group presented higher bone mineral density than the control group at both 3 and 6 months after treatment (P<0.05). In addition, the levels of WBC and ESR were markedly reduced at 3 and 6 months after treatment in both patient groups when compared with pretreatment levels (P<0.05), and further decreased at 6 months after treatment compared with 3 months after treatment within each group (P<0.05); the observation group had lower WBC and ESR levels than the control group at 3 and 6 months after treatment, with statistically significant differences (P<0.05)

Vitamin D shock therapy has a good effect on critically ill cases of chronic osteomyelitis after trauma, which can improve bone metabolism markers and bone density.