Vitamin D Management and Nonunion in Elective Foot and Ankle Arthrodesis

Category: Other; Ankle; Ankle Arthritis; Bunion; Hindfoot; Midfoot/Forefoot Introduction/Purpose: Bone health and more specifically, vitamin D status, have become a focus across multiple orthopedic subspecialties as a modifiable determinant of health. Improved bone health and nutritional optimization can function preventatively by curtailing problems such as osteoporotic fractures but can also function to optimize operative outcomes contingent upon successful bone-to-bone healing, such as arthrodesis. Investigations on this topic are relatively lacking in the orthopedic foot and ankle literature and to date, are limited mostly to epidemiologic study designs that have reported on prevalence of hypovitaminosis D. To the best of our knowledge, there have been no attempts to associate vitamin D status with nonunion and no inquiries into the perioperative management strategies for hypovitaminosis D in the elective foot and ankle arthrodesis population. Methods: Records from all elective foot and ankle arthrodesis procedures performed by the senior author between 2013 and 2019 were obtained. These procedures ranged in complexity from single joint hallux interphalangeal arthrodesis to multiple joint deformity correction arthrodesis. It has been standard practice for the senior author to obtain a preoperative vitamin D level on all patients indicated for arthrodesis and treat accordingly during the perioperative period for cases of hypovitaminosis D (