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Current Issue - July 2023, Volume 17, Issue No. 2

Official Journal of Malaysian Orthopaedic Association and ASEAN Orthopaedic Association

Fracture Liaison Service and Its Role in Secondary Fracture Prevention in Malaysia: A Scoping Review


  1. Kanis JA, Oden A, Johnell O, Jonsson B, de Laet C, Dawson A. The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int. 2001; 12(5): 417-27. doi: 10.1007/s001980170112
  2. Murray CJL, Aravkin AY, Zheng P, Abbafati C, Abbas KM, Abbasi-Kangevari M, et al. Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the global burden of disease study 2019. Lancet. 2020; 396(10258): 1223-49. doi: 10.1016/S0140-6736(20)30752-2
  3. Borgström F, Karlsson L, Ortsäter G, Norton N, Halbout P, Cooper C, et al. Fragility fractures in Europe: burden, management and opportunities. Arch Osteoporos. 2020; 15(1): 59. doi: 10.1007/s11657-020-0706-y
  4. Odén A, McCloskey EV, Kanis JA, Harvey NC, Johansson H. Burden of high fracture probability worldwide: secular increases 2010-2040. Osteoporos Int. 2015; 26(9): 2243-8. doi: 10.1007/s00198-015-3154-6
  5. Ong T, Khor HM, Kumar CS, Singh S, Chong E, Ganthel K, et al. The Current and Future Challenges of Hip Fracture Management in Malaysia. Malays Orthop J. 2020; 14(3): 16-21. doi: 10.5704/MOJ.2011.004
  6. Lim HT, Chong E, Yau WK, Abdul-Halim H. Outcomes and Impact of Fragility Fracture among Geriatrics Patients who Underwent Hip Surgery in Hospital Kuala Lumpur. Malays Orthop J. 2022; 16(1): 84-90. doi: 10.5704/MOJ.2203.012
  7. Cheung CL, Ang SB, Chadha M, Chow ES, Chung YS, Hew FL, et al. An updated hip fracture projection in Asia: The Asian Federation of Osteoporosis Societies study. Osteoporos Sarcopenia. 2018; 4(1): 16-21. doi: 10.1016/j.afos.2018.03.003
  8. Klotzbuecher CM, Ross PD, Landsman PB, Abbott TA 3rd, Berger M. Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res. 2000; 15(4): 721-39. doi: 10.1359/jbmr.2000.15.4.721
  9. van Geel TA, van Helden S, Geusens PP, Winkens B, Dinant GJ. Clinical subsequent fractures cluster in time after first fractures. Ann Rheum Dis. 2009; 68(1): 99-102. doi: 10.1136/ard.2008.092775
  10. Elliot-Gibson V, Bogoch ER, Jamal SA, Beaton DE. Practice patterns in the diagnosis and treatment of osteoporosis after a fragility fracture: a systematic review. Osteoporos Int. 2004; 15(10): 767-78. doi: 10.1007/s00198-004-1675-5
  11. Javaid MK, Sami A, Lems W, Mitchell P, Thomas T, Singer A, et al. A patient-level key performance indicator set to measure the effectiveness of fracture liaison services and guide quality improvement: a position paper of the IOF Capture the Fracture Working Group, National Osteoporosis Foundation and Fragility Fracture Network. Osteoporos Int. 2020; 31(7): 1193-1204. doi: 10.1007/s00198-020-05377-1
  12. Wu CH, Tu ST, Chang YF, Chan DC, Chien JT, Lin CH, et al. Fracture liaison services improve outcomes of patients with osteoporosis-related fractures: A systematic literature review and meta-analysis. Bone. 2018; 111: 92-100. doi: 10.1016/j.bone.2018.03.018
  13. Gallacher S, Alexander S, Beswetherick N, Carr W, Durber A, Gittoes N, et al. Effective secondary prevention of fragility fractures: clinical standards for Fracture Liaison Services. Royal Osteoporosis Society. 2019. (accessed on 14 December 2022)
  14. Yeap SS, Nur Fazirah MFR, Nur Aisyah C, Zahari Sham SY, Samsudin IN, C Thambiah S, et al. Trends in post osteoporotic hip fracture care from 2010 to 2014 in a private hospital in Malaysia. Osteoporos Sarcopenia. 2017; 3(2): 112-6. doi: 10.1016/j.afos.2017.05.001
  15. Pang GHM, Chong EGM, Razali RM, Lee FS, Yau WK. 61 Hip fracture management of older adults in a public tertiary hospital in Kuala Lumpur: analysis and comparison with the standard of care in UK. Age Ageing. 2019; 48(Supplement_4): iv13-7. doi: 10.1093/ageing/afz164.61
  16. Cheah MH, Ong T, Lai PSM, Khor HM. Treatment initiation and continuation of inpatients with fragility fractures in a Tertiary Teaching Hospital in Malaysia. Australas J Ageing. 2021: 40: 71-2.
  17. Tay CL, Ng WL, Beh HC, Lim WC, Hussin N. Screening and management of osteoporosis: a survey of knowledge, attitude and practice among primary care physicians in Malaysia. Arch Osteoporos. 2022; 17(1): 72. doi: 10.1007/s11657-022-01111-y
  18. Peters MDJ, Marnie C, Colquhoun H, Garritty CM, Hempel S, Horsley T, et al. Scoping reviews: reinforcing and advancing the methodology and application. Syst Rev. 2021; 10: 263. doi: 10.1186/s13643-021-01821-3
  19. International Osteoporosis Foundation. Map of Best Practice. (accessed on 5 May 2023)
  20. International Osteoporosis Foundation. Fracture Liaison Service (Fls) Beacon Hospital, Selangor, Malaysia. (accessed on 14 December 2022)
  21. Leong JF, Teh JX, Azizi Z, Levin KB, Rizal AR, Ahmad Farihan MD, et al. Impact of Fracture Liaison Service in managing fragility fracture at tertiary hospital center, Malaysia. Osteoporos Sarcopenia. 2019; 5(4), Suppl): S20. doi: 10.1016/j.afos.2019.12.023
  22. Leong JF, Teh JX, Zainodin A, Belani LS, Ashraff M, Ariff M, et al. Osteoporosis care gap following fragility fracture in a tertiary teaching hospital. J Comm Med and Pub Health Rep. 2021; 2(4). doi: 10.38207/Jcmphr20210076
  23. Leong JF, Shaibi SS, Ng ZL, Belani LK, Rani RA, Don AF, et al. Compliance to anti-osteoporotic therapy after one year follow-up with fracture liaison service in tertiary university hospital, Malaysia. Osteoporos Int. 2022; 31(Suppl 1):S418-9.
  24. Lee JK. "Take action for bone health". J Orthop Surg (Hong Kong). 2021; 29(3): 23094990211059857. doi: 10.1177/23094990211059857
  25. The Economist Intelligence Unit Limited 2021. Integrated care pathways for bone health: An overview of global policies. 2021. (accessed on 14 December 2022)
  26. Clinical Practice Guidelines: Management of Osteoporosis Ministry of Health Malaysia. 3rd ed. 2022. (accessed on 14 December 2022)
  27. Malaysian Society of Geriatric Medicine. Position Statement on Falls and Fragility Fractures. 2020. (accessed on 14 December 2022)
  28. Fragility Fracture Network of Malaysia (FFNM). Fracture Liaison Service (FLS) Framework. 2022. (accessed on 14 December 2022)
  29. Mitchell PJ, Ang SB, Mercado-Asis LB, Rey-Matias R, Chen WS, Flicker L, et al. Quality improvement initiatives in the care and prevention of fragility fractures in the Asia Pacific region. Arch Osteoporos. 2022; 17(1): 115. doi: 10.1007/s11657-022-01153-2
  30. Royal College of Physicians. Fracture Liaison Service Database (FLS-DB). 2022. (accessed on 14 December 2022)
  31. Subramaniam S, Chan CY, Soelaiman IN, Mohamed N, Muhammad N, Ahmad F, et al. Prevalence and predictors of osteoporosis among the Chinese population in Klang Valley, Malaysia. Appl Sci. 2019; 9(9): 1820. Doi: 10.3390/app9091820
  32. Cooper C, Cole ZA, Holroyd CR, Earl SC, Harvey NC, Dennison EM, et al. Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int. 2011; 22(5): 1277-88. doi: 10.1007/s00198-011-1601-6
  33. Nazrun AS, Tzar MN, Mokhtar SA, Mohamed IN. A systematic review of the outcomes of osteoporotic fracture patients after hospital discharge: morbidity, subsequent fractures, and mortality. Ther Clin Risk Manag. 2014; 10: 937-48. doi: 10.2147/TCRM.S72456
  34. Chandran M. Fracture Liaison Services in an open system: how was it done? what were the barriers and how were they overcome? Curr Osteoporos Rep. 2013; 11(4): 385-90. doi: 10.1007/s11914-013-0162-3
  35. Wu CH, Kao IJ, Hung WC, Lin SC, Liu HC, Hsieh MH, et al. Economic impact and cost-effectiveness of fracture liaison services: a systematic review of the literature. Osteoporos Int. 2018; 29(6): 1227-42. doi: 10.1007/s00198-018-4411-2

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The Malaysian Orthopaedic Journal is a peer-reviewed journal that is published three times a year in both print and electronic online version. The purpose of this journal is to publish original research studies, evaluation of current practices and case reports in various subspecialties of orthopaedics and traumatology, as well as associated fields like basic science, biomedical engineering, rehabilitation medicine and nursing.

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