Leiden University Scholarly Publications

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Gorter, E.A. (2022)

The influence of vitamin D and osteoporosis on fracture healing

Doctoral Thesis
This thesis starts with a comprehensive review of the literature on the role of vitamin D in fracture healing. Followed by three clinical studies on the prevalence of vitamin D deficiency in fracture patients, risk factors and effect of vitamin D status on fracture healing. The second part of this thesis begins with an extensive review on the effect of osteoporosis and its treatment on fracture healing. A retrospective study is performed on the effect of osteoporosis on fracture healing. Also a more fundamental study on osteoporosis is performed, levels of sclerostin are determined in fracture patients with osteoporosis as biomarker. In the appendix of this thesis, two case reports are presented which illustrate the role of vitamin D plays in bone metabolism and fracture healing.
Overall, vitamin D plays a role in fracture healing, although the exact mechanism
remains not fully elucidated. The influence of vitamin D deficiency on fracture
healing cannot be fully ignored,...Show moreThis thesis starts with a comprehensive review of the literature on the role of vitamin D in fracture healing. Followed by three clinical studies on the prevalence of vitamin D deficiency in fracture patients, risk factors and effect of vitamin D status on fracture healing. The second part of this thesis begins with an extensive review on the effect of osteoporosis and its treatment on fracture healing. A retrospective study is performed on the effect of osteoporosis on fracture healing. Also a more fundamental study on osteoporosis is performed, levels of sclerostin are determined in fracture patients with osteoporosis as biomarker. In the appendix of this thesis, two case reports are presented which illustrate the role of vitamin D plays in bone metabolism and fracture healing.
Overall, vitamin D plays a role in fracture healing, although the exact mechanism
remains not fully elucidated. The influence of vitamin D deficiency on fracture
healing cannot be fully ignored, but the exact degree of influence is not determined yet.
Since the high prevalence of vitamin D deficiency found among adult and paediatric
fracture patients, clinicians should be aware of vitamin D deficiency and the prevailing
advice regarding vitamin D supplementation, especially in case of delayed fracture
union or fracture non union.
Although animal studies show a negative effect of osteoporosis on fracture healing,
convincing clinical evidence lack to support this potential association. Since no negative
effect of anti-osteoporosis medication on fracture healing could be determined in
patients, treatment should not be withheld in case of a fracture.
Show less
Vitamin D
Osteoporosis
Fracture healing
Non-union
All authors
Gorter, E.A.
Supervisor
Schipper, I.B.
Co-supervisor
Krijnen, P.; Appelman-Dijkstra, N.M.
Committee
Nelissen, R.G.H.H.; Zillekens, M.C.; Leenen, L.P.H.; Hamdy, N.A.T.; Termaat, M.F.
Qualification
Doctor (dr.)
Awarding Institution
Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
Date
2022-11-09
ISBN (print)
9789463617321

Funding

Sponsorship
Nederlandse Vereniging voor Traumachirurgie; Traumacentrum West