Vitamin D and bone fracture healing

Table 3 Sample of human studies designed to examine vitamin D influence on bone healing

Ref.	Type of Study	Finding
Briggs et al[10]	Examined vitamin D levels in 28 patents with diaphyseal long bone fractures at 48 h, 1 wk and 6 wk	Serum 1,25-dihydroxyvitamin D decreased from baseline, but serum 24R,25(OH)2D levels did not change
Delgado-Martínez et al[22]	Investigated 25-OH-vitamin D effect in elderly with fractures	The addition of the vitamin D supplement improved strength of the fractured bone
Sun et al[25]	Examined effect of vitamin D3 on the differentiation of mesenchymal stem cells from a human fracture site	Vitamin D3 was able to modulate the the differentiation towards osteoblastic phenotype of the cells derived from fracture sites
Doetsch et al[32]	Quantified impact of vitamin D3 + calcium on healing of osteoporotic fracture	Bone mineral density at 6 wk was higher in actively treated group suggesting vitamin D3 had a positive effect 6 wk post fracture, but this was not maintained at 12 wk
Parchi et al[33]	Case report of child post-fracture	Hypovitaminosis D is a possible cause of inadequate fracture healing and refracture in children Vitamin D has a clear effect on callus formation
Boszczyk et al[36]	35 patients with inexplicable fracture healing impairments and controls were studied with regard to vitamin D	No impact of vitamin D deficiency noted
Ettehad et al[37]	Determined serum levels of vitamin D during fracture healing of 73 patients	Serum levels of vitamin D were reduced in curative period, suggesting vitamin D plays a role in the formation and mineralization of callus
Alkalay et al[44]	Assessed vitamin D metabolite levels in 28 patients after fracture, and 27 undergoing surgery	Serum 1,25-dihydroxyvitamin D3 was significantly reduced in the fracture cases
Tauber et al[50]	Determined active metabolites of vitamin D3 in 7 fracture patients	24,25(OH)2D3 levels showed a relative decrease, and a decrease in 1,25(OH)2D3 in 2 cases, suggesting these metabolites are consumed at fracture site during healing
Meller et al[51]	Levels of 25(OH)D3 + 24,25(OH)2D3 were determined in 13 young patients with long bone fractures on admission and after 6-8 wk	Plasma 24,25(OH)2,-D3 levels rose over the 6 wk period, but no changes in 25(OH)D3 levels occurred
Hoikka et al[52]	Treated 37 osteoporotic fracture cases with 1 α, OHD3– dosage 1 ug per day, plus 2.5 gm calcium	1 α-OHD3 impacts fracture healing although 5/19 cases developed hypercalcemia