{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:05:21Z","timestamp":1792098321288,"version":"4.4.0"},"reference-count":115,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2018,10,31]],"date-time":"2018-10-31T00:00:00Z","timestamp":1540944000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>With the increasing incidence of fractures now, and in the future, the absolute number of bone-healing complications such as nonunion development will also increase. Next to fracture-dependent factors such as large bone loss volumes and inadequate stabilization, the nutritional state of these patients is a major influential factor for the fracture repair process. In this review, we will focus on the influence of protein\/amino acid malnutrition and its influence on fracture healing. Mainly, the arginine-citrulline-nitric oxide metabolism is of importance since it can affect fracture healing via several precursors of collagen formation, and through nitric oxide synthases it has influences on the bio-molecular inflammatory responses and the local capillary growth and circulation.<\/jats:p>","DOI":"10.3390\/nu10111597","type":"journal-article","created":{"date-parts":[[2018,10,31]],"date-time":"2018-10-31T11:55:41Z","timestamp":1540986941000},"page":"1597","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Malnutrition and Fracture Healing: Are Specific Deficiencies in Amino Acids Important in Nonunion Development?"],"prefix":"10.3390","volume":"10","author":[{"given":"Dennis M.","family":"Meesters","sequence":"first","affiliation":[{"name":"Department of Surgery, Maastricht University Medical Center, P.O. Box 616, 6200 MD Maastricht, The Netherlands"},{"name":"NUTRIM School for Nutrition and Translational Research in Metabolism, P.O. Box 616, 6200 MD Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karolina A.P.","family":"Wijnands","sequence":"additional","affiliation":[{"name":"Department of Surgery, Maastricht University Medical Center, P.O. Box 616, 6200 MD Maastricht, The Netherlands"},{"name":"NUTRIM School for Nutrition and Translational Research in Metabolism, P.O. Box 616, 6200 MD Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9142-5116","authenticated-orcid":false,"given":"Peter R.G.","family":"Brink","sequence":"additional","affiliation":[{"name":"Department of Surgery, Maastricht University Medical Center, P.O. Box 616, 6200 MD Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5005-1285","authenticated-orcid":false,"given":"Martijn","family":"Poeze","sequence":"additional","affiliation":[{"name":"Department of Surgery, Maastricht University Medical Center, P.O. Box 616, 6200 MD Maastricht, The Netherlands"},{"name":"NUTRIM School for Nutrition and Translational Research in Metabolism, P.O. Box 616, 6200 MD Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,10,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1016\/S8756-3282(01)00602-0","article-title":"Continuously rising problem of osteoporotic knee fractures in elderly women: Nationwide statistics in Finland in 1970\u20131999 and predictions until the year 2030","volume":"29","author":"Kannus","year":"2001","journal-title":"Bone"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/S8756-3282(01)00614-7","article-title":"Epidemiology of fractures in England and Wales","volume":"29","author":"Dennison","year":"2001","journal-title":"Bone"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1007\/s00198-004-1702-6","article-title":"Epidemiology of osteoporotic fractures","volume":"16","author":"Johnell","year":"2005","journal-title":"Osteoporos. 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