Proximal tibia fracture in a patient with incomplete spinal cord injury associated with robotic treadmill training

Filippo et al.,¹ report on the T-scores of a 43-year-old female, who sustained a fragility fracture, while using the robotic treadmill, Lokomat (Hocoma, Volketswil, Switzerland). The patient’s menopausal status was not outlined. However, at 43 years of age, she is likely to have been pre-menopausal. Is it not widely accepted that for pre-menopausal females and males under 60 years of age z-scores are used in determining fracture risk?^2,3 Unless, there is uniformity in the reporting of bone mineral density, development of protocols as advocated by the authors, will remain a significant challenge.