Abstract 83: Frax score does not accurately identify patients who need anti-osteoporotic treatment: A cross sectional study among elderly Indian men and postmenopausal women with a low trauma forearm fracture

Background: Early identification and treatment of osteoporosis decreases the risk of major osteoporotic fractures which cause significant morbidity and economic burden. Forearm fractures are a forerunner of hip fractures. Identifying the most sensitive method for differentiating those who requires osteoporotic treatment from others in the high risk age group is important for the resource limited nations. Aims and Objectives: Consecutive postmenopausal females and males above 50 years with incident low trauma forearm fracture attending a tertiary care hospital in South India were studied to assess which method (DXA-BMD vs FRAX) would have best predicted the need for treatment in such patients. Results: Sixty-four subjects (59 females and 5 males) with mean age of 63.01± 8.46 years were enrolled in the study. Forty-four (69%) subjects had T score < -2.5 at hip or spine as an indication for treatment. Using NOF guidelines FRAX tool identified 20 (31%) patients as requiring treatment while FRAX (without BMD) would have identified only 8 (12%) (p<0.05). By using the cut offs suggested by ISBMR for Indians, only 16 (25 %) and 6 (9%) using FRAX (with and without BMD respectively) would have been identified (p<0.01). Conclusions: FRAX with BMD is a better tool compared to that without BMD to identify subjects who requires anti-osteoporotic treatment in males above 50 years and postmenopausal females who sustained low trauma forearm fracture.