Centre Hospitalo-Universitaire Jean Minjoz

" Our FLS was set up in 2019 for inpatients. Patients hospitalized for a fragility fracture are daily -or every other day- identified in orthopedic surgery and neurosurgery departments by a resident rheumatologist. We are also increasingly solicited by our geriatricians, internists and pneumologists colleagues since the implementation of the FLS.

For each patient, a clinical and biological evaluation is systematically performed. An evaluation of bone mineral density by DXA (Lunar) is also performed, most often after a short delay from the fracture (because of pain), for patients for whom DXA is of interest for the introduction (most often, wrist or costal fractures) or for the follow-up of the treatment. 

If there are no contraindications, treatment is started during hospitalization to avoid patients lost to follow-up. In case of a contraindication, treatment is started during a remote consultation (3-4 months). For some patients, a treatment is carried out in a day hospital with a rheumatology consultation for the introduction of the treatment, +/- a geriatrics consultation, +/- a stomatology consultation, +/- a DXA.

Patient follow-up is carried out by either the referring rheumatologist of the FLS, or the patient's usual rheumatologist if he had one before the fracture, or by the general practitioner with the instruction to send the patient back to rheumatology consultation at the end of the therapeutic sequence. "