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Charcot neuroarthropathy (CN) of the foot and ankle is a demanding clinical dilemma, and surgical management can be very complicated. Historically, the evidence guiding surgical management of CN has been small retrospective case series and expert opinions. The purpose of the present report was to provide a systematic review of studies published from 2009 to 2014 and to review the indications for surgery. A Medline search was performed, and a systematic review of studies discussing the surgical management of CN was undertaken. Thirty reports fit the inclusion criteria for our study, including 860 patients who had undergone a surgical procedure for the treatment of CN. The surgical procedures included amputation, arthrodesis, debridement of ulcers, drainage of infections, and exostectomy. The midfoot was addressed in 26.9% of cases, the hindfoot in 41.6%, and the ankle in 38.4%. Of the 30 studies, 24 were retrospective case series (level 4), 4 were controlled retrospective studies (level 3), and 2 were level II studies. The overall amputation rate was 8.9%. The quality of the published data on the surgical management of CN has improved during the past several years. Evidence concerning the timing of treatment and the use of different fixation methods remains inconclusive.

Charcot neuropathic osteoarthropathy (CN) of the foot and ankle is a poorly understood destructive process that poses a great clinical challenge to foot and ankle specialists. Neuropathic fractures or dislocations in the foot and ankle predispose patients to increased morbidity, premature mortality, and can greatly decrease quality of life. Early recognition and treatment of CN is imperative to prevent the development of permanent deformities. The purpose of this article is to review the history, cause, and classification of CN and to discuss commonly used internal fixation techniques and their indications.

The majority of injuries during sport are to the lower extremity (more than 50%), most of which occur in children and young adults younger than 25 years and involve fractures, ligament injuries, or tendon injuries. This article discusses the etiology of some of the most common foot and ankle sports-related injuries. The authors focus on clinical findings, associated injuries, pathophysiology, and current trends. Many of these factors are discussed in detail elsewhere in this issue.

Adolescent hallux valgus is a challenging pathologic entity that differs from adult onset hallux valgus. It is most commonly seen in females, and genetic predisposition plays a strong role in its development. Evaluation and treatment of this pathologic process are unique and both clinical and radiographic findings are considered. Surgical treatment is initiated when conservative measures fail and it should be for relief of pain, not for cosmesis. The authors' preferred treatment is to avoid surgery until skeletal maturity; however, if surgical treatment is required, distal chevron osteotomy is our treatment of choice. Proximal osteotomies are avoided in the skeletally immature patient.