Fracture Liaison Service


Lead Author(s): 

Kenneth S. Saag, MD, MSc

Coordination of acute postfracture care with subsequent secondary osteoporosis prevention and treatment is a tenet of good osteoporosis management. Although most people who experience a fracture receive excellent and appropriate acute care management in a hospital or emergency department, most are not subsequently referred to or do not pursue postfracture osteoporosis care with a bone health specialist.

The fracture liaison service (FLS) is a model of care developed in Europe and successfully implemented in a number of US managed health care systems that seeks to facilitate postfracture care coordination. FLS operates under the supervision of bone health specialists and collaborates with primary care, orthopedic, and emergency department health care providers. Care typically is coordinated postfracture through a nurse or other allied health professional. Patients with recent fractures are tracked via a registry, and timelines are established for postfracture assessments and follow-ups. FLS programs recognize that patients who have fractured are at highest risk of future fractures. FLS programs in certain settings have reduced the number of fractures and have achieved cost savings by identifying and appropriately treating postfracture patients.

The efficiency of the FLS approach varies depending on its intensity and potentially the location of its implementation.1,2

  • 1. Ganda K, Puech M, Chen JS, et al.: Models of care for the secondary prevention of osteoporotic fractures: A systematic review and meta-analysis. Osteoporos Int 2013 Feb;24(2):393-406. doi: 10.1007/s00198-012-2090-y. Epub 2012 Jul 25.
  • 2. Solomon DH, Patrick AR, Schousboe J, Losina E: The potential economic benefits of improved post-fracture care: A cost-effectiveness analysis of a fracture liaison service in the US healthcare system. J Bone Miner Res 2014 Jul;29(7):1667-1674. doi: 10.1002/jbmr.2180.


  • 2014

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