Perioperative Nutrition Optimization for Reducing Complications After Surgical Fracture Fixation

Inclusion Criteria: 1. Adults age 18-55 years 2. Open or closed fracture of the lower extremity including femur, tibia and/or fibula, calcaneus, talus, Lisfranc joint (OTA/AO 31, 32, 33, 41, 42, 43, 44, 4F, 81, 82, 83, 85) 3. Ability to begin supplementation within 72 hours of injury Exclusion Criteria: 1. BMI \<18.5 kg/m 2 (underweight) or BMI \> 45 kg/m 2 (severe obesity) to exclude patients with severely increased baseline risk of adverse outcome due to preoperative poor nutrition 2. Non-ambulatory prior to injury 3. Currently pregnant 4. Medical contraindication to CEAA supplementation (e.g., phenylketonuria) 5. Inability to provide informed consent due to intellectual disability 6. Protected populations (e.g., prisoners) 7. Inability to follow up (e.g., homeless at time of surgery, home address out of state of treating facility) 8. Documented dementia, mild or moderate traumatic brain injury 9. Inability to consume supplement or placebo due to head or neck trauma 10. Low-energy fragility fracture (i.e. ground level falls) 11. Pathologic fracture (i.e. fracture through site of compromised bone due to infection, neoplasm, documented osteoporosis, metabolic bone disease from conditions such as end stage renal disease, osteomalacia, hypophosphatemic rickets, renal osteodystrophy, osteofibrous dysplasia)