Structural decay of bone is not fully assessed by current current X-ray gold standard, i.e., Dual X-ray absorptiometry (DXA), and there is an unmet need in identifying women at risk of fracture who should receive a treatment. Recent Bi-Directional Axial Transmission (BDAT) techniques exploit the multimode waveguide response of long bones such as the radius. The objective of this ex vivo study was to evaluate the performance of a prototype BDAT device to discriminate between fractured and non-fractured specimens under realistic fall loading conditions. Thirty radii from elderly donors (79 y.o. +/- 12 y.o., 15 males, 15 females) underwent AT measurements using a 1-MHz prototype (Azalee, Paris, France). Singular value decomposition-based approach, combined with a 2-D transverse isotropic free plate waveguide model, was used to estimate cortical thickness and porosity. The radius were loaded at 2 m.s(-1) using a servo-hydraulic testing machine to mimic impact that corresponds to a fall. Radii were measured by Dual X-Ray absorptiometry to obtain bone mineral density values (g.cm(-2)) at radius distal end. Among the 30 radii, 14 had a fracture after the impact, leading to two groups (fractured F and non-fractured NF). Fracture prediction was significant for the subgroup F with Ct.Th and Ct.Po odds ratios [ORs] equals to 2.27 and 2.35 and areas under the receiver operating characteristic (ROC) curve [AUCs] to 0.74 and 0.76 lower than BMD (AUC = 0.81). When adjusted on radius diameter, AUC was equal to 0.80 and 0.82 for Ct.Po and DXA respectively. These results suggest that the multimode AT has the potential to yield cortical bone parameters to predict fracture risk in postmenopausal women.