{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T19:03:39Z","timestamp":1785179019637,"version":"3.55.0"},"reference-count":23,"publisher":"British Editorial Society of Bone & Joint Surgery","issue":"2","license":[{"start":{"date-parts":[[2013,2,1]],"date-time":"2013-02-01T00:00:00Z","timestamp":1359676800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/online.boneandjoint.org.uk\/TDM"}],"content-domain":{"domain":["online.boneandjoint.org.uk"],"crossmark-restriction":true},"short-container-title":["The Bone &amp; Joint Journal"],"published-print":{"date-parts":[[2013,2]]},"abstract":"<jats:p> We analysed retrospectively the risk factors leading to femoral overgrowth after flexible intramedullary nailing in 43 children (mean age 7.1 years (3.6 to 12.0)) with fractures of the shaft of the femur. We reviewed their demographic data, mechanism of injury, associated injuries, the type and location of the fractures, the nail\u2013canal diameter (NCD) ratios and femoral overgrowth at a mean follow-up of 40.7 months (25.2 to 92.7). At that time, the children were divided into two groups, those with femoral overgrowth of &lt; 1\u00a0cm (Group 1), and those with overgrowth of \u2265 1\u00a0cm (Group 2). The mean femoral overgrowth of all patients was 0.6 cm at final follow-up. Overgrowth of \u2265 1\u00a0cm was noted in 11 children (25.6%). The NCD ratio was significantly lower in Group 2 than in Group 1, with an odds ratio of 30.0 (p = 0.003). <\/jats:p><jats:p> We believe that a low NCD ratio is an indicator of an unstable configuration with flexible intramedullary nailing, and have identified an association between a low NCD ratio and femoral overgrowth resulting in leg-length discrepancy after flexible intramedullary nailing in paediatric femoral shaft fractures. <\/jats:p><jats:p> Cite this article: Bone Joint J 2013;95-B:254\u20138. <\/jats:p>","DOI":"10.1302\/0301-620x.95b2.29491","type":"journal-article","created":{"date-parts":[[2013,1,30]],"date-time":"2013-01-30T17:18:30Z","timestamp":1359566310000},"page":"254-258","update-policy":"https:\/\/doi.org\/10.1302\/crossmark-policy","source":"Crossref","is-referenced-by-count":35,"title":["Risk factors for overgrowth after flexible intramedullary nailing for fractures of the femoral shaft in children"],"prefix":"10.1302","volume":"95-B","author":[{"given":"S-S.","family":"Park","sequence":"first","affiliation":[{"name":"Asan Medical Center, University of Ulsan\rCollege of Medicine, Department of Orthopaedic\rSurgery, 88, Olympic-ro\r43-gil, Songpa-gu, Seoul\r138-736, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Noh","sequence":"additional","affiliation":[{"name":"Asan Medical Center, University of Ulsan\rCollege of Medicine, Department of Orthopaedic\rSurgery, 88, Olympic-ro\r43-gil, Songpa-gu, Seoul\r138-736, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Kam","sequence":"additional","affiliation":[{"name":"Asan Medical Center, University of Ulsan\rCollege of Medicine, Department of Orthopaedic\rSurgery, 88, Olympic-ro\r43-gil, Songpa-gu, Seoul\r138-736, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"42","reference":[{"key":"r1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.70B1.3339064"},{"key":"r2","unstructured":"Beaty JH, Kasser JR. 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