GLP-1 Receptor Agonist Use in Patients Undergoing Distal Radius Fracture Surgery: A Retrospective Review of Perioperative Considerations.

INTRODUCTION

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly prescribed for glycemic control and weight loss, but their effects on surgical outcomes remain incompletely understood. Delayed gastric emptying and associated perioperative risks have prompted updated anesthetic guidelines, although evidence in orthopaedic or hand surgery remains limited. This study aims to evaluate the prevalence of GLP-1 RA use and its perioperative implications among patients undergoing surgical fixation for distal radius fractures (DRFs).

METHODS

A retrospective review of 4,811 adult patients undergoing operative treatment for DRFs between 2019 and 2024 was conducted. GLP-1 RA use prior to surgery was identified through medication reconciliation. Demographics, comorbidities, medication type, and postoperative complications, including nausea, vomiting, abdominal pain, aspiration, emergency visits, and hospital readmissions, were assessed.

RESULTS

GLP-1 RA use was observed in 46 patients (1.0%) over a six-year period, with prevalence rising from 0.4% to 0.5% annually between 2019 and 2022 (three to four patients each year) to 1.0% in 2023 (eight out of 808 patients) and to 2.9% in 2024 (23 out of 781 patients). Semaglutide was the most commonly used agent in the cohort. Only one GLP-1 user (2.2%, one out of 46) experienced postoperative nausea. There were no cases of aspiration or serious complications documented.

CONCLUSION

GLP-1 RA use among orthopaedic trauma patients is increasing, reflecting broader prescribing trends. In this cohort, perioperative complications were rare, although underreporting may be a factor. The retrospective nature of the study and the relatively small number of GLP-1 users limit the generalizability of the findings. Nonetheless, orthopaedic surgeons should be aware of potential anesthetic considerations, evolving guidelines, and the importance of coordinated perioperative planning as GLP-1 use expands.