Ahmed M, Durcan L, O'Beirne J, Quinlan J, Pillay I
South Tipperary General Hospital, Western road, Clonmel, Co Tipperary.
Ir Med J. 2012 Jan;105(1):24, 26-7.
Fracture liaison services (FLS) aim to provide cost-effective targeting of secondary fracture prevention. It is proposed that a dedicated FLS be available in any hospital to which a patient presents with a fracture. An existing orthopaedic clinic nurse was retrained to deliver a FLS. Proformas were used so that different nurses could assume the fracture liaison nurse (FLN) role, as required. Screening consisted of fracture risk estimation, phlebotomy and DXA scanning. 124 (11%) of all patients attending the orthopaedic fracture clinic were reviewed in the FLS. Upper limb fractures accounted for the majority of fragility fractures screened n=69 (55.6%). Two-thirds of patients (n=69) had reduced bone mineral density (BMD). An evidence based approach to both non-pharmacological and pharmacotherapy was used and most patients (76.6%) receiving pharmacotherapy received an oral bisphosphonate (n=46). The FLS has proven to be an effective way of delivering secondary prevention for osteoporotic fracture in a non-regional fracture clinic, without increasing staff costs.
骨折联络服务（FLS）旨在以具有成本效益的方式开展继发性骨折预防工作。建议在任何有骨折患者就诊的医院都应设立专门的骨折联络服务。一名现有的骨科门诊护士接受了再培训以提供骨折联络服务。使用了统一格式的表格，以便不同的护士能够根据需要承担骨折联络护士（FLN）的职责。筛查包括骨折风险评估、静脉穿刺采血和双能X线吸收法扫描。在骨科骨折门诊就诊的所有患者中，有124例（11%）在骨折联络服务中接受了评估。上肢骨折占筛查出的脆性骨折的大多数，为69例（55.6%）。三分之二的患者（69例）骨密度（BMD）降低。对非药物治疗和药物治疗均采用了循证方法，接受药物治疗的大多数患者（76.6%）接受了口服双膦酸盐治疗（46例）。事实证明，骨折联络服务是在非地区性骨折门诊开展骨质疏松性骨折二级预防的有效方式，且不会增加人员成本。
