Fracture Liaison Service

For older adults, one break all too frequently leads to another.

Studies have shown that anyone age 50 or older who suffers a fragility fracture – a bone break sustained in a fall from a standing height or less – is 2 to 5 times more likely to experience a second fracture than someone who hasn’t had one. The odds that a person who’s suffered 2 such fractures will have a third are even higher.

At Wake Forest Baptist Health, our fracture liaison service is a multispecialty, preventive-care program designed to foster bone health in older adults, thereby reducing the risk of fragility fractures.

If you are 50 years old or older and have had a fracture, or if your provider feels that you will benefit from a bone health evaluation, our fracture liaison service could be a resource to help you. Our goal is to help our patients to minimize the risk of another fragility fracture.

The initial visit for each patient includes a thorough review of your medical history and a physical examination. Depending on what those reveal, lab tests, X-rays and a bone-density scan may be administered.

After all the results are collected and analyzed, you will receive an individualized plan that may include an exercise program, dietary and lifestyle recommendations, non-prescription supplements and prescription medications, all geared toward increasing bone health and decreasing the risk of future breaks.

Follow-up visits are scheduled as needed, during which your progress is evaluated and your care plan is adjusted, if necessary.

About Fragility Fractures

The underlying cause for the vast majority of non-traumatic fractures is osteoporosis, a progressive disease that decreases the weight and density of bones, making them more brittle. Osteoporosis doesn’t have any obvious symptoms so in most cases it isn’t noticed until a fracture occurs – and those fractures are anything but rare.

“Orthopaedics has traditionally focused on fixing the fracture, but we’ve realized that is only part of our responsibility as physicians,” says Cynthia Emory, MD, orthopaedic surgeon. “Identifying and treating the underlying cause is equally important so we can prevent fractures from occurring and enable our patients to continue doing the activities they enjoy.”

About Fracture Liaison Service Programs

Well-established and with proven records of success abroad, notably in the United Kingdom and Canada, fracture liaison service programs are catching on in the United States, thanks in part to initiatives by the National Osteoporosis Foundation, National Bone Health Alliance (NBHA), American Orthopaedic Association and other organizations.

Wake Forest Baptist was one of the first academic medical centers in the country to establish a formal fracture liaison service program, an effort led by Emory and certified nurse practitioner Anne Lake, who serves as the program’s coordinator.

The service provides “full-perspective care coordination,” says Lake, whose job as fracture liaison service coordinator includes gathering all the information about the patients, developing their therapy plans, guiding the patients through the program, and keeping all of their doctors and other caregivers in the loop about their status.

“Orthopaedists and primary-care physicians obviously play major roles,” says Lake, who holds a doctor of nursing practice degree. “But we’ll also consult endocrinologists, rheumatologists, dietitians, physical therapists – basically anyone who can contribute to determining what’s best for the individual patient.”