The role of vitamin D in fracture healing: Insights from basic science, clinical studies, and future directions

Vitamin D plays a critical role in maintaining skeletal health, regulating calcium and phosphate homeostasis, facilitating cellular differentiation, and preventing fractures. However, increasing emphasis is being placed on its potential role in accelerating fracture healing. Multiple in vitro studies have evaluated the significant involvement of vitamin D in all three phases of the healing process, suggesting that supplementation could improve outcomes. Given the rising prevalence of vitamin D deficiency in the United States, there is increasing interest in exploring this as an adjunct therapy to support optimal fracture healing. Published animal studies have demonstrated that post-fracture vitamin D supplementation can expedite radiographic healing by improving blood flow, stimulating the proliferation and differentiation of osteoprogenitor cells, and enhancing bone mineralization. Despite these promising preclinical results, the effects of vitamin D supplementation on fracture healing translating to clinical practice remain limited, with human studies showing mixed results. This literature review offers a comprehensive overview of fracture healing, highlighting the biological role of vitamin D and the potential impact of supplementation on the healing process.