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Abstract Background This study aimed to demonstrate the occurrence of lower extremity deformities and their risk factors in patients with solitary osteochondromas. Methods We retrospectively reviewed consecutive patients with solitary osteochondromas around the knee. The laterality (left or right), involved bone (femur or tibia), tumor type (pedunculated or sessile), and direction (medial or lateral) were examined. The whole limb length (WLL), mechanical lateral distal femoral angle (mLDFA), and medial proximal tibial angle (MPTA) were measured using teleroentgenogram. Lower limb deformity was defined as a difference of more than 5° in mLDFA or MPTA in both lower extremities or a difference in WLL of more than 1 cm. Patients were divided into two groups, with deformity and without deformity. Results Lower extremity deformities were observed in 8 of 83 patients. Significant difference in the type of osteochondroma (p = 0.004) between the groups was observed. Differences in sex, age, laterality, involved bone, direction, and distance from the physis to the osteochondroma between groups were not statistically significant. The sessile type of osteochondroma was a risk factor for lower limb deformity with an odds ratio of 24.0 according to Firth’s logistic regression analysis. Conclusion In our cohort with solitary osteochondroma, lower limb deformities were observed in 8 (9.6%) out of the 83 patients and these were significantly associated with sessile-type tumors. Therefore, patients with sessile-type solitary osteochondroma around the knee require careful surveillance of lower limb alignment with whole leg teleroentgenogram.

Abstract Background The rotational change after using a flexible intramedullary (IM) nail for femoral shaft fractures has been a concern for many surgeons. Recently, a statistical shape model (SSM) was developed for the three-dimensional reconstruction of the femur from two-dimensional plain radiographs. In this study, we measured postoperative femoral anteversion (FAV) in patients diagnosed with femoral shaft fractures who were treated with flexible IM nails and investigated age-related changes in FAV using the SSM. Methods This study used radiographic data collected from six regional tertiary centers specializing in pediatric trauma in South Korea. Patients diagnosed with femoral shaft fractures between September 2002 and June 2020 and patients aged 20° was 32.74°, and the LMM showed that FAV decreased by 2.5° (p = 0.0001) with each 1-year increase from the time of initial trauma. Conclusions This study explored changes in FAV after femoral shaft fracture using a newly developed technology that allows 3D reconstruction from uncalibrated 2D images. There was a pattern of change on the rotation of the femur after initial fixation, with a 2.5° decrease of FAV per year.

Abstract Background This study aimed to translate and transculturally adapt the English version of the Pedi-IKDC questionnaire into Korean and evaluate the psychometric properties of the Korean Pedi-IKDC questionnaire in terms of internal consistency, feasibility (floor and ceiling effect), construct validity, test-retest reliability, and factor analysis. Methods The original English version of the Pedi-IKDC questionnaire was translated and transculturally adapted into Korean according to established guidelines. A total of 239 patients aged 7–18 years who visited the hospital because of knee pain or discomfort were considered eligible for the study. These patients completed the Korean version of the Pedi-IKDC and Pediatric Quality of Life questionnaires (PedsQL). The correlation between the PedsQL and Pedi-IKDC questionnaires was assessed to confirm the validity of the questionnaire. To verify the validity of the Korean Pedi-IKDC questionnaire, internal consistency, feasibility, test-retest reliability, and construct validity were evaluated, and a factor analysis was performed. Results Internal consistency was found to be satisfactory in all subscales (Cronbach’s alpha ≥ 0.7). The test-retest reliability was satisfactorily high for all subscales (Intraclass correlation coefficient: 0.81–0.84). A high correlation was observed between the total Pedi-IKDC score and the score on the physical-health subscale of child version of the PedsQL (Correlation coefficients: 0.720). There were no floor effects in all subscales, but ceiling effects were observed in four questions. Additionally, factor analysis suggested that the questionnaire could be divided into two subscales. Conclusion The Korean version of the Pedi-IKDC questionnaire was successfully translated and transculturally adapted according to the established guidelines. The Korean Pedi-IKDC questionnaire has been proven reliable and valid.