Care After a Fracture

After experiencing a fracture (i.e. a bone break) over age 50, it is important to rule out whether that fracture may be related to osteoporosis or weakening and thinning bone structure and prevent any future fractures. Appropriate after-fracture care should include follow-up tests, a bone density scan (DEXA/DXA scan), discussion about treatment options, and the development of a personalized plan to help make sure another fracture is prevented.  

These follow-up steps and others are part of “Fracture Liaison Services” (FLS).  

What are ‘Fracture Liaison Services’ (FLS)?

Fracture Liaison Services (FLS) are coordinated fracture prevention services that are made up of a team of healthcare providers who work together to help someone avoid experiencing second or multiple fractures after having experienced a first one.  

An FLS team includes the patient and their health care provider (PCP), and usually includes a bone health specialist, a radiologist, an orthopedic surgeon, and others who all work together to help prevent future fractures.  

If someone does have osteoporosis without prior knowledge, an FLS can increase the likelihood of diagnosis by 95%, which means that person can take active control over their condition to help prevent future fractures with treatment options, lifestyle changes, and more. 

How Should I Know If I Need Fracture Liaison Services (FLS) Or After Fracture Follow-up?

You might be wondering if you need the support of Fracture Liaison Services (FLS). The answer is: If you are 50 years of age or older and have fractured (broken) a bone, you need after fracture follow-up care, and should ask for FLS.

Questions You Might Expect at an Initial Visit with an FLS Team or Your HealthCare Provider After a Fracture (bone break)

To help prepare for a visit, we have listed questions below that your healthcare provider or FLS team member may ask you after your fracture: 

• Have you broken any other bones since you turned 50? (if over 50) 
• Have you had a bone density screening (a DEXA/DXA scan). If so, when was it done? 
• What medications do you take? How long have you been taking them? 
• Are you on corticosteroids, radiation, or chemotherapy? If so, for how long? 
• Do you live with any chronic conditions like inflammatory arthritis, inflammatory bowel disease, diabetes, asthma, or cardiovascular issues? 
• Have you ever been told you have osteoporosis, weak or brittle bones, or bone loss? 
• Have you ever been told you have a vitamin D or calcium deficiency? 
• Do you take any vitamin D or calcium supplements? How much and how often? 

Questions You Might Ask Your Health Care Provider (or FLS team) After Experiencing a Fracture

As we all know, sometimes we must be our own advocate when it comes to our health. After experiencing a fracture (or bone break) over the age of 50, if your doctor doesn’t ask you the questions above (and especially if you haven’t been connected with FLS), you might want to ask  these questions: 

• Can you tell me about my follow-up care options, like Fracture Liaison Services (FLS)? 
• Can you schedule me for a bone density screening (DEXA/DXA scan)? 
• How can I prevent future fractures other than lifestyle changes and getting more vitamin D and calcium? 
• What resources do you have that can help me learn more about improving or maintaining my bone health? 

Will Insurance Cover Fracture Liaison Services (FLS)?

Medical bills can be frustrating, confusing, and can add stress to an already stressful situation. Fracture Liaison Services (FLS) are usually considered a medical necessity by most insurance providers and are typically covered to a certain extent by insurance. This is because if someone is using FLS, it is because that person has experienced at least one fracture and needs to ensure the risk for another is minimalized to the extent possible.  

Be sure to check with your insurance provider, though, to find out what kinds of after-fracture care services are covered and whether FLS is included. Some insurance providers cover 100 percent of costs for FLS and related after-fracture care services.