Thickening of the femoral shaft cortical bone has been mentioned in reports of atypical subtrochanteric and diaphyseal (S/D) femur fractures. These authors examine the relationship of cortical thickness to S/D fracture risk in a large cohort of older women. However they found no evidence that thick femoral cortices placed women at higher risk for low-energy S/D femur fractures; in fact, the opposite was true. Women with thin cortices were at a higher risk for femoral neck and intertrochanteric fractures.
Napoli N, Jin J, Peters K, Wustrack R, Burch S, Chau A, et al