Introduction: Osteoporosis is a significant public health problem, contributing to fragility fractures that lead to prolonged periods of immobilization, dependence, and a poor quality of life. Early detection and screening for osteoporosis are therefore critical. Radiographic analysis with Singh’s index and the Calcaneal index, which assess the trabecular bone pattern, remain essential tools for osteoporosis screening in settings where advanced diagnostic tools such as DEXA and quantitative ultrasound (QUS) are unavailable.

Objective: This study aimed to examine the correlation between Singh’s index and the Calcaneal index in patients aged 60 years and above presenting with distal radius fragility fractures, with a focus on the reliability of these indices as screening tools for osteoporosis.

Methodology: A cross-sectional study was conducted among 65 patients aged 60 years and above with distal radius fractures at Government Medical College, Kozhikode. Data collected included patient demographics, fracture characteristics, and radiological features. Singh’s index and the Calcaneal index were evaluated from radiographs, and statistical analysis was performed to assess the correlation between the two indices.

Results: The study revealed a statistically significant correlation (p<0.05) between the two indices in the study population. Patients with higher grades of osteoporosis in either index exhibited a greater probability of sustaining fragility fractures, indicating that both indices are reliable indicators of bone density in elderly patients.

Conclusion: The Calcaneal index and Singh’s index are significantly correlated and can be used effectively for screening for osteoporosis in resource-limited settings offering a cost-effective, practical solution for identifying individuals at risk and helping prevent further morbidity.