Vitamin D Status and Fracture Healing: A Systematic Review of 63 Studies
Category: Other Introduction/Purpose: There is little consensus on the effects of vitamin D on fracture healing. This review aims to clarify that effect in addition to determining trends in the classification of deficiency and supplementation. Methods: This systematic review searched Pubmed, Embase,...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2022-11-01
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| Series: | Foot & Ankle Orthopaedics |
| Online Access: | https://doi.org/10.1177/2473011421S00943 |
| _version_ | 1797983905389740032 |
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| author | Priya K. Singh MSc Lucy O'Sullivan Ashish Vankara Micheal Raad Amiethab A. Aiyer MD |
| author_facet | Priya K. Singh MSc Lucy O'Sullivan Ashish Vankara Micheal Raad Amiethab A. Aiyer MD |
| author_sort | Priya K. Singh MSc |
| collection | DOAJ |
| description | Category: Other Introduction/Purpose: There is little consensus on the effects of vitamin D on fracture healing. This review aims to clarify that effect in addition to determining trends in the classification of deficiency and supplementation. Methods: This systematic review searched Pubmed, Embase, and Web of Science for manuscripts related to vitamin D status/deficiency and fracture healing. Two independent reviewers screened articles, graded evidence quality, and extracted data. A total of 38 human studies, 11 in vivo studies and 14 systematic reviews were analyzed. Results: The median vitamin D deficiency prevalence reported amongst the human studies was 41.2% which is comparable to subset of patients with deficiency defined as <20 ng/mL, 43.3%. Amongst the 9 human studies reporting vitamin D supplementation, the exact dosage varied greatly. No RCTs reported any radiographic evidence of increased fracture union with any form of supplementation. Several RCTs reported reduction in pain with smaller daily supplementation compared to placebo or single large boluses. Animal studies reported mixed results, with some showing no significant effects of vitamin D status on the biomechanical properties of bone, while others demonstrated a correlation between supplementation improved biomechanical stiffness. Furthermore, the metabolite 24,25D may be a mediator in Vitamin D's probable osteoprotective effects. Conclusion: While the role of vitamin D in fracture healing appears to be osteoprotective in animal models, the degree and significance of its effects on human fracture healing and prevention remains inconclusive. We recommend standardizing the definitions for vitamin D deficiency to be <20 ng/mL for deficiency and >30 ng/mL for sufficiency. Although there is no radiographic evidence, daily smaller doses of vitamin D supplementation seem to have a stronger impact on clinical fracture healing than large boluses. |
| first_indexed | 2024-04-11T06:54:43Z |
| format | Article |
| id | doaj.art-8814a91348eb4f9593c91b92a9c9f0e2 |
| institution | Directory Open Access Journal |
| issn | 2473-0114 |
| language | English |
| last_indexed | 2024-04-11T06:54:43Z |
| publishDate | 2022-11-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Foot & Ankle Orthopaedics |
| spelling | doaj.art-8814a91348eb4f9593c91b92a9c9f0e22022-12-22T04:39:04ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142022-11-01710.1177/2473011421S00943Vitamin D Status and Fracture Healing: A Systematic Review of 63 StudiesPriya K. Singh MScLucy O'SullivanAshish VankaraMicheal RaadAmiethab A. Aiyer MDCategory: Other Introduction/Purpose: There is little consensus on the effects of vitamin D on fracture healing. This review aims to clarify that effect in addition to determining trends in the classification of deficiency and supplementation. Methods: This systematic review searched Pubmed, Embase, and Web of Science for manuscripts related to vitamin D status/deficiency and fracture healing. Two independent reviewers screened articles, graded evidence quality, and extracted data. A total of 38 human studies, 11 in vivo studies and 14 systematic reviews were analyzed. Results: The median vitamin D deficiency prevalence reported amongst the human studies was 41.2% which is comparable to subset of patients with deficiency defined as <20 ng/mL, 43.3%. Amongst the 9 human studies reporting vitamin D supplementation, the exact dosage varied greatly. No RCTs reported any radiographic evidence of increased fracture union with any form of supplementation. Several RCTs reported reduction in pain with smaller daily supplementation compared to placebo or single large boluses. Animal studies reported mixed results, with some showing no significant effects of vitamin D status on the biomechanical properties of bone, while others demonstrated a correlation between supplementation improved biomechanical stiffness. Furthermore, the metabolite 24,25D may be a mediator in Vitamin D's probable osteoprotective effects. Conclusion: While the role of vitamin D in fracture healing appears to be osteoprotective in animal models, the degree and significance of its effects on human fracture healing and prevention remains inconclusive. We recommend standardizing the definitions for vitamin D deficiency to be <20 ng/mL for deficiency and >30 ng/mL for sufficiency. Although there is no radiographic evidence, daily smaller doses of vitamin D supplementation seem to have a stronger impact on clinical fracture healing than large boluses.https://doi.org/10.1177/2473011421S00943 |
| spellingShingle | Priya K. Singh MSc Lucy O'Sullivan Ashish Vankara Micheal Raad Amiethab A. Aiyer MD Vitamin D Status and Fracture Healing: A Systematic Review of 63 Studies Foot & Ankle Orthopaedics |
| title | Vitamin D Status and Fracture Healing: A Systematic Review of 63 Studies |
| title_full | Vitamin D Status and Fracture Healing: A Systematic Review of 63 Studies |
| title_fullStr | Vitamin D Status and Fracture Healing: A Systematic Review of 63 Studies |
| title_full_unstemmed | Vitamin D Status and Fracture Healing: A Systematic Review of 63 Studies |
| title_short | Vitamin D Status and Fracture Healing: A Systematic Review of 63 Studies |
| title_sort | vitamin d status and fracture healing a systematic review of 63 studies |
| url | https://doi.org/10.1177/2473011421S00943 |
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