{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T18:33:31Z","timestamp":1771266811551,"version":"3.50.1"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:sec>\n            <jats:title>Objectives:<\/jats:title>\n            <jats:p>The purpose was to evaluate economic benefit of calcium and vitamin D supplementation in orthopaedic trauma patients. We hypothesized that reduced nonunion rates could justify the cost of supplementing every orthopaedic trauma patient.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design:<\/jats:title>\n            <jats:p>Retrospective, economic model.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting:<\/jats:title>\n            <jats:p>Level 1 trauma center.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patients\/Participants:<\/jats:title>\n            <jats:p>Adult patients over 3 consecutive years presenting with acute fracture.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Intervention:<\/jats:title>\n            <jats:p>Operative or nonoperative fracture management.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Main Outcome Measurements:<\/jats:title>\n            <jats:p>Electronic medical records were queried for <jats:italic toggle=\"yes\">ICD-9<\/jats:italic> code for diagnosis of nonunion and for treatment records of nonunion for fractures initially treated within our institution.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>In our hospital, a mean of 92 (3.9%) fractures develop nonunion annually. A 5% reduction in nonunion risk from 8 weeks of vitamin D supplementation would result in 4.6 fewer nonunions per year. The mean estimate of cost for nonunion care is $16,941. Thus, the projected reduction in nonunions after supplementation with vitamin D and calcium would save $78,030 in treatment costs per year. The resulting savings outweigh the $12,164 cost of supplementing all fracture patients during the first 8 weeks of fracture healing resulting in a net savings of $65,866 per year.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Vitamin D and calcium supplementation of orthopaedic trauma patients for 8 weeks after fracture seems to be cost effective. Supplementation may also reduce the number of subsequent fractures, enhance muscular strength, improve balance in the elderly, elevate mood leading to higher functional outcome scores, and diminish hospital tort liability by reducing the number of nonunions.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Level of Evidence:<\/jats:title>\n            <jats:p>Economic Level V. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/bot.0000000000000592","type":"journal-article","created":{"date-parts":[[2016,3,23]],"date-time":"2016-03-23T13:29:53Z","timestamp":1458739793000},"page":"e285-e288","source":"Crossref","is-referenced-by-count":17,"title":["Economic Benefit of Calcium and Vitamin D Supplementation: Does It Outweigh the Cost of Nonunions?"],"prefix":"10.1097","volume":"30","author":[{"given":"Benjamin R.","family":"Childs","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brendan A.","family":"Andres","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather A.","family":"Vallier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20230829","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1056\/NEJMra070553","article-title":"Vitamin D deficiency","volume":"357","author":"Holick","year":"2007","journal-title":"N Engl J Med."},{"key":"R2-20230829","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1097\/BOT.0b013e318274da8b","article-title":"Physiological challenges of bone repair","volume":"26","author":"Borrelli","year":"2012","journal-title":"J Orthop Trauma."},{"key":"R3-20230829","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1097\/BOT.0b013e31814d4dc6","article-title":"Metabolic and endocrine abnormalities in patients with nonunions","volume":"21","author":"Brinker","year":"2007","journal-title":"J Orthop Trauma."},{"key":"R4-20230829","first-page":"705","article-title":"Prevalence of vitamin D deficiency and secondary hyperparathyroidism in nonunion of traumatic fracture","volume":"51","author":"Pourfeizi","year":"2013","journal-title":"Acta Med Iran."},{"key":"R5-20230829","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1007\/s00223-004-0167-0","article-title":"The effect of calcium and vitamin D3 supplementation on the healing of the proximal humerus fracture: a randomized placebo-controlled study","volume":"75","author":"Doetsch","year":"2004","journal-title":"Calcif Tissue Int."},{"key":"R6-20230829","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/s00402-012-1650-0","article-title":"Calcium homeostasis influences radiological fracture healing in postmenopausal women","volume":"133","author":"Kolb","year":"2013","journal-title":"Arch Orthop Trauma Surg."},{"key":"R7-20230829","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1002\/jor.1100160604","article-title":"Effect of 25-OH-vitamin D on fracture healing in elderly rats","volume":"16","author":"Delgado-Mart\u00ednez","year":"1998","journal-title":"J Orthop Res."},{"key":"R8-20230829","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1016\/j.bone.2009.01.378","article-title":"Effect of 1, 25-dihydroxy vitamin D 3 on fracture healing and bone remodeling in ovariectomized rat femora","volume":"44","author":"Fu","year":"2009","journal-title":"Bone"},{"key":"R9-20230829","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1007\/BF00390051","article-title":"Biomechanical analysis of the effects of single high-dose vitamin D3 on fracture healing in a healthy rabbit model","volume":"116","author":"\u00d6mero\u011dlu","year":"1997","journal-title":"Arch Orthop Trauma Surg."},{"key":"R10-20230829","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/j.bone.2014.04.026","article-title":"The role of vitamin D in human fracture healing: a systematic review of the literature","volume":"64","author":"Gorter","year":"2014","journal-title":"Bone"},{"key":"R11-20230829","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1177\/2151458511408568","article-title":"Is supplementation of vitamin D beneficial for fracture healing? A short review of the literature","volume":"2","author":"Eschle","year":"2011","journal-title":"Geriatr Orthop Surg Rehabil."},{"key":"R12-20230829","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1097\/BOT.0000000000000455","article-title":"What is the role of vitamin D supplementation in acute fracture patients? A systematic review and meta-analysis of the prevalence of hypovitaminosis D and supplementation efficacy","volume":"30","author":"Sprague","year":"2016","journal-title":"J Orthop Trauma."},{"key":"R13-20230829","doi-asserted-by":"crossref","first-page":"2257","DOI":"10.1001\/jama.293.18.2257","article-title":"Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials","volume":"293","author":"Bischoff-Ferrari","year":"2005","journal-title":"JAMA"},{"key":"R14-20230829","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/S0140-6736(07)61342-7","article-title":"Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis","volume":"370","author":"Tang","year":"2007","journal-title":"Lancet"},{"key":"R15-20230829","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.bone.2014.08.002","article-title":"Calcium and vitamin D supplementation maintains parathyroid hormone and improves bone density during initial military training: a randomized, double-blind, placebo controlled trial","volume":"68","author":"Gaffney-Stomberg","year":"2014","journal-title":"Bone"},{"key":"R16-20230829","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1007\/s00198-015-3386-5","article-title":"Calcium plus vitamin D supplementation and risk of fractures: an updated meta-analysis from the National Osteoporosis Foundation","volume":"27","author":"Weaver","year":"2016","journal-title":"Osteoporos Int."},{"key":"R17-20230829","doi-asserted-by":"crossref","first-page":"115","DOI":"10.2340\/00015555-0980","article-title":"Factors influencing vitamin D status","volume":"91","author":"Tsiaras","year":"2011","journal-title":"Acta Derm Venereol."},{"key":"R18-20230829","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1016\/j.jada.2005.03.002","article-title":"Adolescent girls in Maine are at risk for vitamin D insufficiency","volume":"105","author":"Sullivan","year":"2005","journal-title":"J Am Diet Assoc."},{"key":"R19-20230829","doi-asserted-by":"crossref","first-page":"e362","DOI":"10.1542\/peds.2009-0051","article-title":"Prevalence and associations of 25-hydroxyvitamin D deficiency in US children: NHANES 2001\u20132004","volume":"124","author":"Kumar","year":"2009","journal-title":"Pediatrics"},{"key":"R20-20230829","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1515\/JPEM.2007.20.7.817","article-title":"Prevalence of vitamin D insufficiency in obese children and adolescents","volume":"20","author":"Smotkin-Tangorra","year":"2007","journal-title":"J Pediatr Endocrinol Metab."},{"key":"R21-20230829","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1186\/1475-2891-10-51","article-title":"Serum 25-hydroxyvitamin D is inversely associated with body mass index in cancer","volume":"10","author":"Vashi","year":"2011","journal-title":"Nutr J."},{"key":"R23-20230829","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/1471-2474-14-42","article-title":"Tibia shaft fractures: costly burden of nonunions","volume":"14","author":"Antonova","year":"2013","journal-title":"BMC Musculoskelet Disord."},{"key":"R24-20230829","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/j.injury.2006.08.055","article-title":"Health economics: a cost analysis of treatment of persistent fracture non-unions using bone morphogenetic protein-7","volume":"38","author":"Dahabreh","year":"2007","journal-title":"Injury"},{"key":"R25-20230829","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1007\/s00264-008-0709-6","article-title":"A cost analysis of treatment of tibial fracture nonunion by bone grafting or bone morphogenetic protein-7","volume":"33","author":"Dahabreh","year":"2009","journal-title":"Int Orthop."},{"issue":"suppl 2","key":"R26-20230829","doi-asserted-by":"crossref","first-page":"S77","DOI":"10.1016\/S0020-1383(07)80012-X","article-title":"The health economics of the treatment of long-bone non-unions","volume":"38","author":"Kanakaris","year":"2007","journal-title":"Injury"},{"key":"R27-20230829","doi-asserted-by":"crossref","first-page":"542","DOI":"10.3111\/13696998.2015.1019887","article-title":"Low-intensity pulsed ultrasound (LIPUS) can decrease the economic burden of fracture non-union","volume":"18","author":"Mehta","year":"2015","journal-title":"J Med Econ."},{"key":"R30-20230829","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1016\/S0020-1383(01)00076-6","article-title":"Antegrade locked intramedullary nailing in humeral shaft fractures","volume":"32","author":"Ajmal","year":"2001","journal-title":"Injury"},{"key":"R31-20230829","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1097\/00003086-198802000-00021","article-title":"Trochanteric osteotomy for revision total hip arthroplasty 97% union rate using a comprehensive approach","volume":"227","author":"Schutzer","year":"1988","journal-title":"Clin Orthop Relat Res."},{"key":"R32-20230829","doi-asserted-by":"crossref","first-page":"1725","DOI":"10.1016\/j.injury.2013.09.009","article-title":"Fracture non-union: can biomarkers predict outcome?","volume":"44","author":"Pountos","year":"2013","journal-title":"Injury"},{"issue":"suppl 3","key":"R33-20230829","article-title":"Deformity and non-union after long bone fractures: litigation, negligence and costs","volume":"96","author":"Harrison","year":"2014","journal-title":"Bone Joint."},{"key":"R34-20230829","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.1097\/01.JGP.0000240986.74642.7c","article-title":"Vitamin D deficiency is associated with low mood and worse cognitive performance in older adults","volume":"14","author":"Wilkins","year":"2006","journal-title":"Am J Geriatr Psychiatry."},{"key":"R35-20230829","first-page":"5","article-title":"Vitamin D vs broad spectrum phototherapy in the treatment of seasonal affective disorder","volume":"3","author":"Gloth","year":"1999","journal-title":"J Nutr Health Aging."},{"key":"R36-20230829","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.1056\/NEJM199212033272305","article-title":"Vitamin D3 and calcium to prevent hip fractures in elderly women","volume":"327","author":"Chapuy","year":"1992","journal-title":"N Engl J Med."},{"key":"R37-20230829","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1056\/NEJM199709043371003","article-title":"Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older","volume":"337","author":"Dawson-Hughes","year":"1997","journal-title":"N Engl J Med."},{"key":"R38-20230829","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1093\/ajcn\/84.1.18","article-title":"Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes","volume":"84","author":"Bischoff-Ferrari","year":"2006","journal-title":"Am J Clin Nutr."},{"key":"R39-20230829","doi-asserted-by":"crossref","first-page":"252","DOI":"10.2105\/AJPH.2004.045260","article-title":"The role of vitamin D in cancer prevention","volume":"96","author":"Garland","year":"2006","journal-title":"Am J Public Health."},{"key":"R40-20230829","first-page":"1557","article-title":"The trauma survivors network: survive. Connect. Rebuild","volume":"70","author":"Bradford","year":"2011","journal-title":"J Trauma."},{"key":"R41-20230829","doi-asserted-by":"crossref","first-page":"e451","DOI":"10.1097\/BOT.0000000000000366","article-title":"Effectiveness of vitamin D therapy in orthopaedic trauma patients","volume":"29","author":"Robertson","year":"2015","journal-title":"J Orthop Trauma."},{"key":"R42-20230829","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1111\/j.1365-2265.2012.04518.x","article-title":"Treatment of hypovitaminosis D with pharmacologic doses of cholecalciferol, oral vs intramuscular; an open labeled RCT","volume":"78","author":"Zabihiyeganeh","year":"2013","journal-title":"Clin Encodrinol (Oxf)."}],"container-title":["Journal of Orthopaedic Trauma"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/00005131-201608000-00014","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T19:27:56Z","timestamp":1693337276000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00005131-201608000-00014"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,8]]},"references-count":39,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2016]]}},"URL":"https:\/\/doi.org\/10.1097\/bot.0000000000000592","relation":{},"ISSN":["0890-5339"],"issn-type":[{"value":"0890-5339","type":"print"}],"subject":[],"published":{"date-parts":[[2016,8]]}}}