In the U.S., greater than half of boys and one quarter of girls in the 8- t
o 16-yr-old age range are engaged in some type of competitive, scholastic,
organized sport juring the school year. Children and adolescents are becomi
ng more involved in sports at earlier ages and with higher levels of intens
ity. Foot and ankle problems, in particular, are the second most common mus
culoskeletal problem facing primary care physicians in children under 10 yr
of age next to acute injury, This report focuses on foot and ankle problem
s, trauma, and overuse in the young athletic population. Guidelines are giv
en for both conservative and surgical management. Specific problems address
ed include pes planus, tarsal coalition, adolescent bunion, os trigonum, ac
cessory navicular, physeal fractures, sprains, peroneal tendon subluxation,
metatarsal fractures, sesamoid fractures, turf toe, stress fractures, tend
onitis, osteochondritis dissecans, ankle impingement, bursitis, Haglund's d
eformity, sesamoiditis, plantar fasciitis, apophysitis, osteochondroses, cu
boid syndrome, and reflex sympathetic dystrophy. An extensive review of the
literature is performed and presented in combination with the extensive ex
perience of a well-established sports medicine clinic at the Boston Childre
n's Hospital.