The study subjects will be selected from among the patients with bone fractures of the
lower limbs who are hospitalized in the orthopedic department of Ayatollah Taleghani
University Hospital in Tehran. The following criteria will be used to determine which
patients are eligible for inclusion in the study:
Inclusion criteria: patients aged 18 to 60 years, candidates for orthopedic surgery for
bone fractures of the lower limbs, ambulatory without assistance for a minimum of two
months prior to the fracture, not having undergone amputation of the lower limbs, not
suffering from liver cirrhosis, not suffering from advanced kidney failure (blood
creatinine higher than 1.4 mg/dL), not having metastatic cancer. Additionally, subjects
must not have any chronic inflammatory diseases, nor must they be taking any drugs that
affect bone metabolism, including calcitonin, bisphosphonates, and corticosteroids.
Furthermore, subjects must not be taking any anti-inflammatory drugs.
Subjects will be excluded from the study if they experience an allergic or intolerant
reaction to Narangenin capsules, if there are any abnormal changes in their liver,
kidneys tests, or if they fail to consume more than 10% of their capsules in weekly
monitoring.
Subjects will be randomly assigned to one of two intervention groups (Narangenin
capsules) or a control group receiving a placebo. Patient assignment will be conducted
using the stratified permuted block randomization method. Patients will be randomly
assigned to one of two intervention groups (narangenin capsules) or a control group
(placebo) based on their history of diabetes. Each stratum will consist of four cases,
with two cases assigned to the placebo group and two cases assigned to the naringenin
group. To ensure the blinding of the study, the capsules will be identical in appearance
and packaged in the same containers. Each capsule of the intervention group will contain
250 mg of naringenin, while each capsule of the control group will contain 250 mg of
starch. The capsules are administered to the patients by the nursing staff, who are
unaware of the patient grouping. The supplementation regimen will commence one day
following surgery, with participating patients receiving two capsules (equivalent to 500
mg) daily for 14 days. Subsequently, following a 14-day period, the patients will resume
the maintenance dose of 250 mg per day until the 90th day post-surgery. During the
intervention period, patients will be monitored for regular use of the capsules and any
adverse reactions. Patients will be required to attend the hospital's
orthopedic clinic on two occasions: 14 days after surgery and three months after surgery.
During these visits, fasting blood samples will be taken for biochemical tests. The
fusion status of patients will be evaluated by radiography after surgery, 14 days, and
three months after surgery. Additionally, functional testing (Oswestry disability index
(ODI)) will be performed two weeks and three months after surgery.