There is high quality evidence that vitamin D plus calcium is associated with a statistically significant reduction in incidence of new non-vertebral fractures .
Vitamin D alone is unlikely to prevent fractures in the doses and formulations tested so far in older people .
Supplements of vitamin D and calcium may prevent hip or any type of fracture .
There was a small but significant increase in gastrointestinal symptoms and renal disease associated with vitamin D and calcium .
This review found that there was no increased risk of death from taking calcium and vitamin
BACKGROUND Vitamin D and related compounds have been used to prevent  osteoporotic fractures in older people .
This is the third up date of a Cochrane review first published in 1996 .
OBJECTIVES To determine the effects of vitamin D or related compounds , with or without calcium , for preventing  fractures in post-menopausal women and older men .
Annual injection of vitamin D and fractures of aged bones
Summary In order to investigate the effect of a supplementation of vitamin D in the prophylaxis of fractures of the bones of aged people , an annual intramuscular injection of ergocalciferol ( 150,000–300,000 IU ) was given to two series of aged subjects : first to 199 ( 45 male ) of 479 subjects ( 110 male ) aged more than 85 years who were living in their own home , and second to 142 ( 29 male ) of 320 ( 58 male ) subjects aged 75–84 and living in a home for aged people . This prospect i ve series was divided into treatment groups according to month of birth . These injections were given annually from September to December in the years 1985–1989 , two to five times to each participant . The fracture rates , laboratory values , vitamin D levels , possible side effects , and mortality were followed until October 1990 . A total of 56  fractures  occurred in the 341 vitamin D recipients ( 16.4 % ) and 100 in 458 controls ( 21.8 % ) ( P=0.034 ) . The fracture rate was about the same in both outpatient and municipal home series . Fractures of the upper limb were fewer in the vitamin D recipients , 10/341=2.9 % ( P=0.025 ) , than in the controls , 28/458=6.1 % , during the follow-up . A similar result was obtained in fractures of ribs , 3/341=0.9 % and 12/458=2.6 % , respectively . Fractures of the lower limbs occurred almost as frequently , 31/341=9.1 % , among the vitamin D recipients as among the controls , 49/458=10.7 % . The fracture rate was higher in females ( 22.2 % ) than in males ( 9.5 % ) . The fractures were fewer in the vitamin D recipients only in females . No significant differences were found in total mortality , or due to any group of diseases , between the two treatment groups . No deleterious effects of the  vitamin D  injections were seen . The authors recommend the supplementation of vitamin D in aged people , at least in northernmost latitudes ( e.g. , as an annual intramuscular injection )
There is high quality evidence that vitamin D plus calcium is associated with a statistically significant reduction in incidence of new non-vertebral fractures .
Vitamin D alone is unlikely to prevent fractures in the doses and formulations tested so far in older people .
Supplements of vitamin D and calcium may prevent hip or any type of fracture .
There was a small but significant increase in gastrointestinal symptoms and renal disease associated with vitamin D and calcium .
This review found that there was no increased risk of death from taking calcium and vitamin
BACKGROUND Vitamin D and related compounds have been used to prevent  osteoporotic fractures in older people .
This is the third up date of a Cochrane review first published in 1996 .
OBJECTIVES To determine the effects of vitamin D or related compounds , with or without calcium , for preventing  fractures in post-menopausal women and older men .