Is Supplementation of Vitamin D Beneficial for Fracture Healing? A Short Review of the Literature

Abstract

There has been a surge of interest regarding the benefits of vitamin D supplementation to prevent fractures. But can it also make them heal more quickly once they have occurred-that is, is supplementation of vitamin D beneficial for fracture healing? We found 13 studies that met our inclusion criteria, 11 of these were performed in animals. Two animal studies showed negative, 2 neutral, and 7 positive results. One clinical case series in humans was inconclusive in our opinion, and one randomized double-blind placebo-controlled trial showed that supplementation of vitamin D 3 and calcium in elderly women with reduced bone mass and a proximal humerus fracture had a positive influence on bone healing. The major weakness of the latter study is low number of participants. A clear statement on the benefits of vitamin D for fracture healing awaits further trials, but all types of fractures in elderly individuals indicate the need for secondary prevention and the implementation of appropriate guidelines concerning falls, vitamin D, and osteoporosis.

Vitamin D and skeletal health in infancy and childhood

“…Animal studies have suggested that vitamin D supplementation can improve fracture healing, but there is a paucity of human data in this area [70], and we could identify none in children. One case-control study in Poland found no difference in serum 25(OH)D in otherwise healthy adults with and without fracture non-union [71].…”

Atypical periprosthetic acetabular fracture in long-term alendronate therapy

“…The final bone healing of the periprosthetic acetabular fracture reported, in our opinion, was achieved through stability of the reconstruction cage after revision surgery and the discontinuation of anti-resorptive treatment, even though the "therapeutical tail", in association with calcium and vitamin D supplements. Studies demonstrated that increasing 25-hydroxyvitamin D levels to optimal (>30 ng/dL) and calcium levels to normal with normalization of parathyroid hormone levels enhances AFs healing (14). In order to promoting AFs healing, case reports and case series showed beneficial effects of anabolic drugs alone (13, 15) (teriparatide and strontium ranelate) or in association with bisphosphonates used in early postoperative period (16)(17)(18).…”

American College of Foot and Ankle Surgeons® Clinical Consensus Statement: Perioperative Management

“…Additionally, evidence has shown an association of vitamin D and bone healing in the published data (167,172,(181)(182)(183)(184)(185)(186). Vitamin D is crucial for ideal bone formation and metabolism and overall health (172,181,182). Vitamin D deficiency has been linked to several health issues, including cardiovascular disease, cancer, autoimmune diseases, diabetes mellitus, hypertension, and multiple sclerosis (186)(187)(188).…”

“…In addition, vitamin D deficiency has been associated with specific bone metabolic diseases, including osteoporosis, osteomalacia, and poor bone growth. Vitamin D deficiency has also been cited as a common cause of stress fracture development and poor fracture healing (181,183,184).…”