Impact of an Outpatient Fracture Liaison Service on Osteoporosis Evaluation Among Patients With Upper Extremity Fragility Fracture

Hand (N Y). 2024 Mar;19(2):256-262. doi: 10.1177/15589447221120851. Epub 2022 Sep 16.

Abstract

Background: The purpose of this study was to assess the impact of implementation of an outpatient fracture liaison service (FLS) on completion rates of dual-energy x-ray absorptiometry (DXA) and screening labs including 25-OH vitamin D and parathyroid hormone (PTH) in patients with upper extremity (UE) fragility fractures.

Methods: At our institution, 367 patients were treated in 2014-2015 for UE fragility fractures of the distal radius and proximal humerus before implementation of our outpatient FLS and 395 patients in 2017-2018 after implementation. Retrospective chart review was conducted to identify completed DXA scans within 2 years of fracture treatment and completed 25-OH vitamin D and PTH labs within 1 year of fracture treatment.

Results: There were no statistical differences in the demographics of patients treated for distal radial and proximal humeral fragility fractures during the 2014-2015 and 2017-2018 time periods. Implementation of the FLS resulted in a 9.9% increase (P value = .021) in completed DXA scans within 2 years of fracture treatment. Completed 25-OH vitamin D and PTH labs saw a significant increase of 17.1% and 23.8%, respectively (P values < .001).

Conclusions: Implementation of an outpatient FLS can help to improve osteoporosis evaluation with completed DXA scans and 25-OH vitamin D and PTH labs.

Keywords: fracture liaison service; fragility fracture; osteoporosis; osteoporosis evaluation; upper extremity.

MeSH terms

  • Arm Injuries*
  • Bone Density Conservation Agents* / therapeutic use
  • Humans
  • Osteoporosis* / complications
  • Osteoporosis* / diagnostic imaging
  • Osteoporotic Fractures* / diagnostic imaging
  • Outpatients
  • Retrospective Studies
  • Upper Extremity / diagnostic imaging
  • Vitamin D / therapeutic use

Substances

  • Bone Density Conservation Agents
  • Vitamin D