Background Studies have shown that trabecular bone score (TBS) is associated with vertebral and non-vertebral fractures in postmenopausal women, and it may have value for assessing microarchitectural deterioration other than low bone mass. There are limited data on the TBS in patients with a distal radius fracture (DRF), which often occurs in the osteopenic or even normal bone mineral density (BMD) ranges.

Objectives The purpose of this study was to compare BMD and TBS in patients with a DRF and propensity score-matched control patients.

Methods We compared BMD and TBS in 269 women with a DRF older than 50 years of age with age- and body mass index (BMI)-matched control patients who had no history of fractures. BMD was measured at the lumbar spine and at the femur using a GE Lunar Prodigy scanner. TBS was calculated on the same spine image. The differences of BMD and TBS between the two groups were assessed. A multivariate logistic regression analysis was used to analyze the odds ratio for the occurrence of DRF for variables such as age, BMI, lumbar or total femur BMD, and the TBS.

Results Patients with a DRF had significantly lower BMDs at the femur (neck, trochanter and total) than control patients (p=0.004, 0.001 and 0.010, respectively). However, BMDs at the lumbar spine and TBS were not significantly different between the groups (p=0.367 and 0.708, respectively). Multivariate analysis indicated that only total femur BMD was significantly associated with the occurrence of DRF (odds ratio, 0.102; 95% confidence interval, 0.018 – 0.569; p=0.009).

Conclusions TBS is not different between women with a distal radius fracture and those without a history of fractures. This result suggests that the TBS measured at the lumbar spine, which is mainly trabecular, may not reflect early microarchitectural changes in the distal radius, which is mainly cortical. BMD at the femur is the reliable evaluation of bone frailty in patients with a DRF.

Disclosure of Interest None declared