Key words: arginine, citrulline, nitric oxide, fracture healing, nonunion

"Amino acids and fracture healing; Insights on the influence of the arginine-citrulline-nitric oxide metabolism during fracture healing and nonunion development"

In spite of major progress in medical sciences over the past decades, 5-10% of all bone fractures fail to heal adequately, resulting in nonunion development. Next to certain comorbidities (e.g. diabetes, smoking, the fracture type and pattern), a compromised nutritional status has a negative effect on fracture repair. One of the key nutrients that has a major influence on fracture healing are the amino acids. The research in this thesis more specifically focused on the amino acid citrulline and the related metabolism. Citrulline is mainly found in watermelons and it is known that in patients with disturbed fracture healing, citrulline and associated compounds are deregulated. When – in an animal model – additional citrulline is supplemented, the period until bone healing is achieved is shortened by approximately 30%.

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