Fracture Liaison Service

 

This guideline applies to adults aged 18 and over.

Introduction

Fragility fractures occur from standing height or less than 2m.  Vertebral fractures may occur spontaneously after usual activities. 

Patients with an osteoporotic wrist fracture have an increased hip fracture risk of 1.4-1.8 fold in women and 2.3-2.7 fold in men.  After a hip fracture the risk of mortality at 1 year is 25%.  After hospitalisation with a hip fracture, 20% of patients require discharge to institutional care.

Please see Osteoporosis Guidelines for full information Osteoporosis (cornwall.nhs.uk)

 

Fracture Liaison Service

The Fracture Liaison Service identifies patients who have sustained a fragility fracture of hip, wrist, humerus, wrist, vertebral, insufficiency and incidental fragility fractures from ED, UTC and MIU.  Patients are provided with a DEXA scan appointment and follow up discussion and shared decision on management as needed.  Advice on bisphosphonate or denosumab treatment will be communicated with the patient’s GP.  If osteoporosis is identified, the Fracture Liaison Service will follow up the patient at 4 and 12 months.  Patients who require secondary care prescribed medication or have fractured on bone protection therapy will be directed to Rheumatology clinic from the service.

Please note no Primary Care referrals are required for this service.  If there is a fragility fracture of another bone, please organise a DEXA and manage accordingly.  The service are hoping to expand to all fragility fractures of any bone site as the service evolves.

 

 

 

 

Page Review Information

Review date	July 2024
Next review date	July 2026
GP speciality lead	Dr R Hopkins
Contributors	Penny Lewis, Lead Osteoporosis Advanced Practitioner, Royal Cornwall Hospitals NHS Trust