Patients With a History of Vitamin D Deficiency Are Not at Increased Risk of Delayed Union Following First Metatarsophalangeal Joint Arthrodesis After Preoperative Optimization.

Background: The correlation between vitamin D levels and bone health has been proven. Vitamin D deficiency is linked to poorer outcomes in osseous surgical procedures. The goal of the present study was to retrospectively investigate the nonunion rates of first metatarsophalangeal joint arthrodesis after implementing a vitamin D optimization protocol. Each patient was tested within 2 months prior to surgery and optimized to at least 20 ng/mL.

Methods: A total of 44 operative extremities were included in this study. We analyzed the time to osseous fusion based on varying vitamin D levels.

Results: There was a low nonunion rate of 2.3%. We found no statistically significant difference in time to fusion based on varying levels of vitamin D of at least 20 ng/mL or in patients who used a bone stimulator. We found no increased risk of delayed or nonunion in patients with a history of deficiency.

Conclusions: We recommend optimizing patients with vitamin D deficiency to a level of at least 20 ng/mL prior to a first metatarsophalangeal arthrodesis procedure.