Reply on “Combined orthogeriatric and fracture liaison service for improved postfracture patient care”

Wewould like to thank Dr. Schweser and colleagues for their interest in our paper [1] and on their agreement that we are missing opportunities to prevent future fractures that can potentially be reduced by the introduction of a fracture liaison service (FLS). From our perspective, we are hoping to use this data locally to push for the introduction of FLS in Malaysian hospitals. Thank you for bringing to our attention the benefits of an orthogeriatric service which can complement the FLS. In countries where there are geriatric services available, this would seem to be a mutually beneficial solution to the problem of long term follow-up of post-hip fracture patients. However, in many parts of Asia which are developing countries, geriatrics as a specialty is poorly developed and geriatricians are a very scarce commodity. Thus, we would suggest that the FLS can be started with the input of any specialty that is interested in osteoporosis and osteoporotic fractures. This would also have the advantage of having the FLS reach out to identify and initiate investigations for patients with other osteoporotic fractures such as vertebral or wrist fractures. Regardless of themethod, we are all in full agreement that treatment after osteoporotic fractures is suboptimal and measures to improve this situation are urgently needed.