[Cohort study of fracture risk before and after surgery of primary hyperparathyroidism]

We studied the risk of fracture in 674 patients operated on for primary hyperparathyroidism compared to 2,021 age- and gender-matched controls, matched for age and gender, randomly drawn from the background population. Before surgery, there was an increased risk of fracture (relative risk 1.8, 9% confidence interval 1.3-2.3), but after surgery the relative risk was normalised (RR = 1.0, 0.8-1.3). The increased risk began ten years before surgery and peaked five to six years before surgery. After surgery, there was a temporary increase in the first year, but in the following years the fracture risk was normalised, with a small rise in distal forearm fractures more than ten years after surgery. Primary hyperparathyroidism may have started up to ten years before surgery, and the fracture risk is normalised after surgery.