Three hundred ninety-four patients with orthopedic trauma were randomized to receive either CEAA supplementation (n=XX) or a standard diet (n=XX). The primary outcome of interest was changes in fat-free mass (FFM). Secondary outcomes included complication rates, surgical site infections, unplanned reoperations, and mortality. Outcomes were assessed at baseline, 2, 6, and 12 weeks postoperatively, with complications monitored up to one year. Overall, the results revealed that patients with open fractures/polytrauma (OF/PT) experienced significant muscle loss at six weeks, while fragility fracture (FFx) patients lost muscle mass at 12 weeks. Patients with isolated fractures (IFx) gained muscle mass at 12 weeks. CEAA supplementation appeared to mitigate muscle loss in the OF/PT and FFx groups and was associated with a reduced risk of non-union, mortality, and total complications. These findings suggest that CEAA supplementation may be particularly beneficial for patients with high-energy trauma and older adults with fragility fractures.