Effect of Vitamin D Supplementation on Fracture Healing: A Systematic Review of Prospective Clinical Trials

Abstract

Background: The relationship of vitamin D status with regard to its deficiency and supplementation in the setting of fracture healing has not been well established. This review aims to evaluate the efficacy of vitamin D on clinical fracture healing Methods: A systematic review of English articles using EMBASE, MEDLINE and the Cochrane Controlled Trials Register was performed. Search terms included vitamin D, cholecalciferol, colecalciferol, hydroxycholecalciferol, calcifediol, calcitriol, dihydroxycholecalciferol, ergocalciferol, dihydrotachysterol, viosterol, 1,25- hydroxyvitamin D, 25-hydroxyvitamin D, 24,25-dihyroxyvitamin D, 25 hydroxyvitamin D, lunacalcipol, vitamin D3 and fracture healing or repair. Only prospective, original trials investigating vitamin D deficiency or its supplementation on fracture related outcomes in humans were included. Results: Overall rates of delayed union in the setting of vitamin D deficiency are low. Vitamin D supplementation appears to have no effect on eventual fracture union in an adult fracture population when assessed by clinical examination and plain radiographs. Conclusions: Prospective, interventional studies of vitamin D supplementation on fracture healing are yet to demonstrate an effect on fracture healing outcome measures.