The basic biological requirements for fracture repair include adequate Hb, growth factors, and pro-inflammatory factor levels to meet the needs of bone tissue and osteoblasts.[42] Anemic patients have a significantly higher rate of nonunion and failure of fracture fixation.[25] This is because anemia restricts oxygen delivery to tissues and organs, leading to cellular hypoxia and disturbances in intracellular homeostasis. The gene discussed is GSTM1; the disease is anemia.