The Center for Podiatric Care and Sports Medicine

Should Teens See NYC Foot Surgeons For Bunions?

Posted by on Friday, March 9th, 2018

Fox News recently reported on the issue of bunions in teenagers. “As many as 30 percent of adolescents deal with bunions, and a large portion of those suffering are girls,” the newspaper states. It may horrify you to learn that your child may have inherited the propensity to develop bunions from you, but the Framington Foot Study of more than 6,000 feet confirmed that nearly 40% of bunion formation went down familial lines.

As a parent, you naturally want to do whatever you can to alleviate your child’s suffering, whether the bunion is causing pain, difficulty finding shoes that fit, or a source of low esteem and embarrassment. The NYC foot surgeons at The Center for Podiatric Care and Sports Medicine have operated on adolescents in the past, but we don’t necessarily agree to every case that walks into our office. Here’s what you should know about bunion surgery for teens.

bunions
Are bunions causing your teen anxiety and depression? NYC podiatrists discuss when to consider surgery. Image Source: Pixabay user soysuperfer.

Teen Bunion Surgery Does Not Always Correct the Underlying Issue

First of all, if your child experiences no pain related to the bunion whatsoever, it is a cosmetic issue, rather than a true medical issue. A plastic surgeon may be inclined to operate in these cases to make a buck, but we do not. Before jumping right to surgery, we have to look at contributing factors to the problem such as improper gait, loading imbalances in the foot, or poorly fitting footwear. If these underlying issues are not addressed, the likelihood of bunion recurrence is great. Duke Orthopaedics’ Textbook of Orthopaedics found the recurrence rate of adolescent bunions to be as high as 60%. For this reason, most surgeons prefer delaying surgery until skeletal maturity is complete—somewhere between 14-17 for girls, and 18-22 for boys.

Bunion Surgery For Teenagers Carries a Risk of Complications

Frankly, no matter how good your surgeon is, any surgery carries a risk of complications and it can be impossible to predict with 100% accuracy how any given body will respond to the disturbance to its homeostasis. A comprehensive literature review published in the Journal of Children’s Orthopaedics observed complication rates of 22.9% for most bunion procedures or as high as 42.3% for the percutaneous method of bunion correction. (In other studies, even the highly praised Lapidus bunionectomy has seen failure rates up to 10%.)

Out of 201 juvenile bunions, researchers noted:

  • 24 cases of significant post-operative pain (11.9%)
  • 16 cases of recurrent deformity (8%) 
  • 9 cases of scar hypersensitivity (4.5%)
  • 8 cases where revision surgery was needed (4%)
  • 4 infections (2%)
  • 1 case of non-union (0.5%)
  • 1 case of metatarsalgia nerve pain (0.5%)
  • 1 case of complex regional pain syndrome (0.5%)
  • 1 case of dissatisfaction with the cosmetic result (0.5%) 

No one wants to be that one worst case scenario, but there are occasional stories of teens who fall victim to infection, necessitating additional surgeries and potential loss of limb.

Adolescent Bunion Surgery Requires Significant Downtime

Another consideration for teenagers is the amount of downtime needed to make a full recovery. Teens are busy with school, social calendars, clubs, and sports. Though techniques have come a long way just in the last decade, full recovery from bunion removal is an estimated four to six months. That can really wreck a summer or take up half the school year. To give you a clearer picture—we’re talking six weeks in a cast or boot, followed by four weeks in a post-operative shoe, doing rehab exercises in our office.

What Bunion Treatments Exist?

Non-surgical treatments will never cause the bony protrusion to go away, but they can sometimes prevent progression or limit the amount of pain. Changing footwear, custom orthotics, bunion padding, foot exercises, and night splints can be helpful interventions. Injection therapy can be performed in cases of severe pain to provide immediate relief.

When is Teen Bunion Removal the Right Option?

Despite the complication rates in the aforementioned study, it should also be noted that the satisfaction rate among teen bunion patients was high (86%), even when the results fell outside clinical and radiological definitions of success. If the presence of a bunion is causing pain or significantly affecting the teen’s quality of life, surgical correction is an option worth exploring. In many cases, insurance will cover some or all of the roughly $5,000 cost.

Get a Professional Opinion On a Teenage Bunion

NYC foot surgeons at The Center for Podiatric Care and Sports Medicine have performed more than 4,000 successful bunion corrections. Reach out to our Manhattan or White Plains office for a consultation about your teenager’s situation. We are happy to answer any questions or concerns you may have, conduct a physical examination, and offer you a comprehensive set of options.

If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.