Lower Limb Fractures in Primary Hyperparathyroidism: A Systematic Review and Meta-Analysis of Incidence, Biochemical Risk Factors, and Surgical Management
Authors' conclusion
Femoral and tibial involvement predominates, reflecting severe cortical compromise. Parathyroidectomy substantially reduces fracture risk.
Study context
- Population
- Patients with primary hyperparathyroidism (PHPT) with reported lower limb fractures; PubMed, Embase, Scopus and Web of Science140 studies
- Comparison
- PHPT patients with vs without lower limb fracture; parathyroidectomy vs no parathyroidectomy
- Outcome
- Pooled prevalence of lower-limb fractures
Methodological detailsPRISMA 2020, observational studies, Risk of bias assessed with the Joanna Briggs Institute Critical Appraisal Checklist
- PRISMA 2020
- Observational studies
- Risk of bias assessed with the Joanna Briggs Institute Critical Appraisal Checklist
Pooled result
As reported in the abstract
Pooled prevalence of lower-limb fractures among included observational cohorts
12%
Further pooled results
| Outcome | Pooled HR |
|---|---|
| Effect of parathyroidectomy on fracture riskReduction in fracture risk after parathyroidectomy | 0.78 |
Serum PTH, calcium and 25(OH)D in patients with vs without fractures
- No significant difference in serum PTH, calcium and 25(OH)D levels in patients with vs without fractures
Original publication
Lower Limb Fractures in Primary Hyperparathyroidism: A Systematic Review and Meta-Analysis of Incidence, Biochemical Risk Factors, and Surgical Management. Endocr Pract. Published 11 August 2026. doi:10.
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