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Nutritional Indicators of Bone Nonunion: A Systematic Review
Eleanor Christianson1, Margaret Thomas2, Sheila Sprague3
1Department of Orthopedic Surgery, Tulane University School of Medicine, New Orleans, LA 70112, USA.
Journal of Clinical Medicine
|November 9, 2024
Summary
Nutritional deficiencies like Vitamin D and iron, along with sarcopenia and malnutrition, are linked to higher bone nonunion risk. Addressing these factors may help prevent nonunion in orthopedic surgery patients.
Area of Science:
- Orthopedic Surgery
- Nutritional Science
- Clinical Research
Background:
- Bone nonunion presents a significant orthopedic challenge impacting patient well-being.
- Established risk factors for nonunion often involve nutritional elements, yet comprehensive exploration is lacking.
Purpose of the Study:
- To systematically review and assess studies associating nutritional factors with bone nonunion.
- To understand the clinical relevance of nutrition in nonunion prevention strategies.
Main Methods:
- A literature review of case-control and cohort studies was conducted using PubMed.
- Studies were selected based on nutritional factors and nonunion risk, with data extraction and bias assessment.
- Included 21 studies published up to July 2024.
Main Results:
- Vitamin D deficiency showed mixed significance (6/12 studies).
- Albumin (3/5 studies), iron deficiency anemia (1/1 study), sarcopenia, nutritional care plans, and dietitian-diagnosed malnutrition were significant predictors.
- Calcium and food insecurity were found to be insignificant in the reviewed studies.
Conclusions:
- Vitamin D, calcium, albumin, iron deficiency anemia, sarcopenia, and clinically diagnosed malnutrition are associated with increased nonunion risk.
- These nutritional factors should be considered in the prevention of bone nonunion.
- Further research may elucidate specific nutritional interventions for nonunion prevention.
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