The Effect of Vitamin D Supplementation for Bone Healing in Fracture Patients: A Systematic Review

While most literature on vitamin D supplementation in fracture patients focuses on fracture prevention, the effect of vitamin D on bone healing is a much less studied concept. The primary aim of this systematic review was to assess whether vitamin D supplementation in fracture patients improves clin...

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Main Authors: Thomas Gatt, Adriana Grech, Homa Arshad
Format: Article
Language:English
Published: Wiley 2023-01-01
Series:Advances in Orthopedics
Online Access:http://dx.doi.org/10.1155/2023/6236045
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author Thomas Gatt
Adriana Grech
Homa Arshad
author_facet Thomas Gatt
Adriana Grech
Homa Arshad
author_sort Thomas Gatt
collection DOAJ
description While most literature on vitamin D supplementation in fracture patients focuses on fracture prevention, the effect of vitamin D on bone healing is a much less studied concept. The primary aim of this systematic review was to assess whether vitamin D supplementation in fracture patients improves clinical or radiological union complications. The secondary aims were to assess supplementation effect on patient functional outcome scores and bone mineral density (BMD). A systematic search of all relevant articles was performed using the following databases: MEDLINE, Embase, Google Scholar, and Web of Science. The population selection included human patients with a fresh fracture treated conservatively or operatively. The intervention included any form of vitamin D supplementation, compared to no supplementation or a placebo. The primary outcomes assessed were clinical or radiological union rates or complications arising from the nonunion. The secondary outcomes assessed were functional outcome scores, BMD scores after treatment, and pain scores. A total of fourteen studies, assessing a total of 2734 patients, were included. Eight studies assessed the effect of vitamin D on clinical or radiological union. Five studies reported no significant difference in complication rates when supplementing fracture patients. Alternatively, three studies reported a positive effect with supplementation between the groups. One of these studies found a difference only for early orthopaedic complications (<30 days), but no differences in late complications. The other two studies found significant differences in clinical union; however, no changes were observed in radiological union. Six studies investigated functional outcome scores after supplementation. Four of these studies found no significant differences between most functional outcome scores. Only three studies reported BMD outcomes, one of which found limited effect on total hip BMD. The overall findings are that vitamin D alone does little to influence fracture healing and subsequent union rates or functional outcome. The studies suggestive of a positive effect were generally of a lower quality. Further high quality RCTs are needed to justify routine supplementation at the time of fracture.
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spelling doaj-art-2d798cc591fd470abb8a136cf80ad7bd2025-08-20T02:07:38ZengWileyAdvances in Orthopedics2090-34722023-01-01202310.1155/2023/6236045The Effect of Vitamin D Supplementation for Bone Healing in Fracture Patients: A Systematic ReviewThomas Gatt0Adriana Grech1Homa Arshad2Mater Dei HospitalMater Dei HospitalQueen Mary UniversityWhile most literature on vitamin D supplementation in fracture patients focuses on fracture prevention, the effect of vitamin D on bone healing is a much less studied concept. The primary aim of this systematic review was to assess whether vitamin D supplementation in fracture patients improves clinical or radiological union complications. The secondary aims were to assess supplementation effect on patient functional outcome scores and bone mineral density (BMD). A systematic search of all relevant articles was performed using the following databases: MEDLINE, Embase, Google Scholar, and Web of Science. The population selection included human patients with a fresh fracture treated conservatively or operatively. The intervention included any form of vitamin D supplementation, compared to no supplementation or a placebo. The primary outcomes assessed were clinical or radiological union rates or complications arising from the nonunion. The secondary outcomes assessed were functional outcome scores, BMD scores after treatment, and pain scores. A total of fourteen studies, assessing a total of 2734 patients, were included. Eight studies assessed the effect of vitamin D on clinical or radiological union. Five studies reported no significant difference in complication rates when supplementing fracture patients. Alternatively, three studies reported a positive effect with supplementation between the groups. One of these studies found a difference only for early orthopaedic complications (<30 days), but no differences in late complications. The other two studies found significant differences in clinical union; however, no changes were observed in radiological union. Six studies investigated functional outcome scores after supplementation. Four of these studies found no significant differences between most functional outcome scores. Only three studies reported BMD outcomes, one of which found limited effect on total hip BMD. The overall findings are that vitamin D alone does little to influence fracture healing and subsequent union rates or functional outcome. The studies suggestive of a positive effect were generally of a lower quality. Further high quality RCTs are needed to justify routine supplementation at the time of fracture.http://dx.doi.org/10.1155/2023/6236045
spellingShingle Thomas Gatt
Adriana Grech
Homa Arshad
The Effect of Vitamin D Supplementation for Bone Healing in Fracture Patients: A Systematic Review
Advances in Orthopedics
title The Effect of Vitamin D Supplementation for Bone Healing in Fracture Patients: A Systematic Review
title_full The Effect of Vitamin D Supplementation for Bone Healing in Fracture Patients: A Systematic Review
title_fullStr The Effect of Vitamin D Supplementation for Bone Healing in Fracture Patients: A Systematic Review
title_full_unstemmed The Effect of Vitamin D Supplementation for Bone Healing in Fracture Patients: A Systematic Review
title_short The Effect of Vitamin D Supplementation for Bone Healing in Fracture Patients: A Systematic Review
title_sort effect of vitamin d supplementation for bone healing in fracture patients a systematic review
url http://dx.doi.org/10.1155/2023/6236045
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