Bariatric surgery and distal radius fractures, a population-based study

Obesity is a growing global concern. Bariatric surgery (BS) is the only intervention which leads to significant and long-lasting weight reduction. However, it has been associated with an increased risk of fracture. We aimed to investigate the association between BS and distal radius fractures (DRF).

A retrospective cohort study of patients with obesity who underwent BS was conducted. The incidence of DRF and the non-osteoporotic scaphoid fracture in the six-years pre-and post-BS was compared. Sub-analysis for surgical type, weight loss, nutritional supplements, and treatment modality was conducted.

Seventeen-thousand, nine-hundred and four patients, aged 40 (SD 2.7) were included in the study, most of whom were females (71.2%). Most underwent restrictive gastric surgery (82.6%). The incidence of both fractures increased following BS (OR 2.091, 95% CI [1.524,2.896], p<0.001 for DRF and OR 6.013, 95% CI [2.819,14.720], p<0.001 for scaphoid fracturs). Women were affected more. DRFs were less common following restrictive surgery (0.6% versus 1.15% for gastric bypass surgery, OR 0.52 95% CI [0.35,0.79], p.=0.002), and their incidence was not associated with the time elapsed from BS. A greater weight reduction was not related with increased fracture risk, regardless of the fracture type, as was nutritional supplements consumption. DRF surgery rates were not affected by BS.

BS was found to relate with increased risk for DRFs. The risk was greater for gastric bypass patients and independent of the increasing cohort age, the amount of weight lost, the time elapsed from surgery, and the intake of nutritional supplements.