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Home/Biologics/Secret to Faster and Better Fracture Healing? Vitamin D
Biologics

Secret to Faster and Better Fracture Healing? Vitamin D

August 1, 2018 1 min read Premium comments

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Secret to Faster and Better Fracture Healing? Vitamin D
Source: Wikimedia Commons and Mikael Haggstrom
Secondary#vitamind#trauma#bonefracture

René St-Arnaud, Ph.D., director of research at Shriners Hospital for Children, in Canada, reports that a Vitamin D metabolite—24,25(OH)2D—results in faster and better bone fracture healing.

His peer reviewed study, which gave both granular detail of the effects of Vitamin D and the analysis of its biology, was published in The Journal of Clinical Investigation.

St-Arnaud reported that to stimulate calcium absorption and assist in bone mineralization, the vitamin D molecule is a critical catalyst in stimulating the bone repair transformation. The first step to bone healing is the transformation of the Vitamin D metabolite—24,25(OH)2D.

He explains that, with the help of another molecule, 24,25(OH)2D synthesizes a waxy fat compound called lactosyl ceramide. This compound triggers the transmission of a signal to the body to increase both the size and biomechanical properties of the callus—which, of course, is the precursor structure to healthy bone that surrounds a fracture and sets the stage for healing.

Test subjects who were not able to produce either 24,25(OH)2D or lactosyl ceramide had smaller and weaker calluses. However, when they were treated with these compounds, both callus size and strength increased. Ensuring a stronger and optimal callus size promoted better fracture healing, St. Arnaud reported.

“In this research, we have identified new biology and a previously unrecognized mechanism of action for a Vitamin D molecule. It is the culmination of more than 15 years of work from my laboratory,” he reported. “The next step,” he said, “is to test these compounds in clinical trials. We hope that they will play an important role in improving fracture repair and healing time.”

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Discussion

14
DS
Dr. Sarah MitchellOrthopedic Surgeon · Mayo Clinic

This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?

8
JT
James Thornton, MDSpine Fellow · HSS

Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.

5
RP
R. PatelSports Medicine · Stanford

We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.

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