Background: An important part of a healthy lifestyle for children and adolescents is exercising to satisfy the natural need for physical activity. However, young athletes should take special care when they participate in intense physical training, to ensure their proper physical development. The aim of this study was to evaluate the body posture in the sagittal plane of soccer players in comparison with healthy untrained peers. Methods: A total of 245 young males aged 8–13 who participated in the study were divided into two groups: “Group F—Footballer”, elite youth soccer players comprising 132 male athletes, and “Group C—Control group”, consisting of 113 boys from primary schools. The elite, youth soccer players played and trained in the Gold Standard Certificate Academy for their age group and belonged to the top 1% of all players from their category, respectively (Polish Soccer Association (PZPN)). The control group consisted of healthy boys from primary schools in Wroclaw not practicing any sport. A photogrammetric method based on the projection moiré phenomenon was used to assess the body posture in all subjects. Results: The analysis showed statistically significant differences in body posture parameters in the sagittal plane between the trained (F) and non-trained (C) groups. In all age groups, a significantly higher value of the upper thoracic angle and a lower value of the trunk inclination angle were observed in the football players’ group. Significant differences were also observed for the thoracic spine in each age group. In the groups of 8–9 and 12–13 years, they concerned the angle of thoracic kyphosis, and in the group of 10–11-year-old, the depth of thoracic kyphosis. In the group of children with ages 8–9 and 10–11, significantly higher values of lumbosacral angle and upper thoracic angle were observed in the group of soccer players. Conclusions: The soccer training load can influence the anterior–posterior curvature of the spine. In the group of footballers in all age groups, higher angular values of thoracic kyphosis and greater tilt of the torso forward were found, compared with their untrained peers. There were also significant differences in body posture between children of different ages, both in the group of footballers and in the group of untrained children. In the group of footballers, the differences concerned mainly the size of the lumbosacral angle and the depth of both curves, which decreased with the age of the players. A similar phenomenon was observed in the group of untrained boys but only in children in the older age groups.

Ankle arthrodesis may have internal or external stabilization. We assessed whether the type of stabilization after ankle arthrodesis will affect: (1) functional outcome in Foot and Ankle Ability Measure (FAAM) scale, (2) pain level, (3) period of hospitalization, (4) rate of complications. We retrospectively studied 47 individuals after ankle arthrodesis with Ilizarov fixation (group 1, n = 21) and internal stabilization (group 2, n = 26) at our institution in years 2007–2015. Clinical outcomes were measure by: (1) functional outcome in FAAM scale, (2) pain level, (3) period of hospitalization, (4) rate of complications. Total number of complications in Ilizarov group was 13, which corresponded to 0.62 complications per patient on average. In group 2 there were 15 complications, which corresponded to 0.58 complications per patient on average. The intergroup difference in rate of complications was not statistically significant (p = 0.066). In group 1 the mean VAS pain level before treatment was 4.69 and after treatment was 1.5 (p = 0.037). In group with internal stabilization the mean VAS pain level before treatment was 4.71 and after treatment was 2.9 (p = 0.044). In group 1 the mean period of hospitalization was 5.29 days, in group 2 was 5.71 days (p = 0.517). In group 1 the mean functional outcome in FAAM scale was 79.38, in group 2 was 70.11 (p = 0.458). Ankle arthrodesis with Ilizarov stabilization is associated with lower prevalence of VAS pain level after surgery than after internal screws stabilization. Rate of complications, FAAM functional score and period of hospitalization were not statistically significant between group 1 and 2. Clinical outcome was satisfactory in group 1 and 2, but outcomes in Ilizarov group were slightly better than after internal stabilization.

A number of various techniques were proposed to stabilized ankle arthrodesis, among them external and internal fixation. Appropriate balance and adequate distribution of lower limb loads determine normal biomechanics of the locomotor system. We hypothesized that various techniques used to stabilize ankle arthrodesis may exert different effects on (1) balance and (2) distribution of lower limb loads. Retrospective analysis included 47 patients who underwent ankle arthrodesis with external stabilization with Ilizarov fixator (group 1, n = 21) or internal stabilization with screws (group 2, n = 26) between 2007 and 2015. Balance and distribution of lower limb loads were determined with a pedobarographic platform. In group 1, average load of the operated and non-operated limb amounted to 48.8% and 51.2%, respectively, and in group subjected to internal stabilization to 48.4% and 51.6%, respectively. Neither the intragroup nor the intergroup differences in the distribution of lower limb loads were statistically significant. Mean length of the center of gravity (COG) path was 137.9 cm for group 1 and 134 cm for group 2, and mean COG area amounted to 7.41 cm2 and 6.16 cm2, respectively. The latter intergroup difference was statistically significant. Balance after ankle arthrodesis with Ilizarov fixation is worse than after the same procedure with internal stabilization. Despite correction of ankle deformity, musculoskeletal biomechanics still remains impaired. While ankle fusion with either Ilizarov or internal fixation provide appropriate distribution of lower limb loads, none of these procedures normalize patients’ balance.

Ankle arthrodesis with the Ilizarov method is an accepted form of treatment of advanced degenerative changes of the ankle joint. Incorrect balance and load distribution on the lower limbs may result in pain and dysfunction. The aim of the study was to assess the change of balance and load distribution in lower extremities in patients before and after ankle arthrodesis with the Ilizarov method. Between 2013 and 2016, ankle arthrodesis using the Ilizarov method was performed on 21 patients. The evaluation of balance and percentage of load in each lower limb was performed before the surgery and during the follow-ups. The evaluation was performed using a Zebris pedobarographic platform. Before the surgery, the patients exhibited an average load of 41.9% of body weight in the affected limb, whereas the load in the healthy limb was 58.1%. The difference was statistically significant (p = 0,000031). In two years follow-up, the average load in the treated limbs was 48.19%, whereas the healthy limbs were subjected to an average load of 51.81%. In preoperative tests, the average path length of the center of gravity was 161.55 cm; postoperatively, the average path length of the center of gravity was 129.7 cm (p = 0.00003206). Preoperatively, the average area of the center of gravity was 18.85 cm²; it decreased to 6.19 cm² (p = 0.000032) postoperatively. Arthrodesis of the ankle with the Ilizarov method improved the statics of the musculoskeletal system by improving the distribution of loads in the lower limbs as well as balance. However, it failed to restore the parameters of a healthy person. Advanced degenerative changes of the ankle disturb the biomechanics of the entire lower limb.