The Center for Podiatric Care and Sports Medicine

Podiatry Concerns in Youngsters: What to Do When Your Child Has a Juvenile Bunion

Posted by on Tuesday, April 29th, 2014

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When we think of bunions, we tend to imagine old ladies who have spent a lifetime of wearing high heel shoes. But in reality, bunions can affect men and women of all ages — especially if a parent has suffered from bunions. “We have seen bunions in children as young as five,” says Dr. Josef Geldwert of The Center for Podiatric Care and Sports Medicine in New York City. “Bunions among teenage girls ages 10 to 17 are far more common than people think.” Fortunately, there are many nonsurgical interventions available for juvenile bunions.

bunions in children
A bunion is a bony growth at the big toe joint.
Image Source: JuvenileFamilyFootcare.com

What Causes Bunions in Children?

The media likes to blame bunions on high heel wearing, but that is obviously not the driving force behind childhood bunions. We believe there are genetic factors at play, although the precise cause is not well understood. We tend to see bunions most frequently in children with flat feet, joint hypermobility, excessive pronation, juvenile rheumatoid arthritis, cerebral palsy, and Down Syndrome.

Bunion Burt
Bunion Burt is a book about a child who needs some help with foot pain.
Image Source: amazon.com

How Are Juvenile Bunions Treated?

The Center for Podiatric Care and Sports Medicine offers many nonsurgical interventions for these big bony lumps at the base of the toe joint. The primary goal of treatment is to manage pain and also address structural issues that could affect gait or development.

First line treatment options to consider for juvenile bunions include:

– Changing shoe type

– Adding padding to the shoe

– Using toe spacers

– Foot exercises

– Wearing an overnight toe splint

– Fitting the child with custom orthotic shoe inserts

We find that bunion splints are particularly effective in stopping the progression of bunions, since children have such malleable feet. Custom orthoses may not prevent the development of inevitable bunions, but it is our experience that shoe inserts work wonders in limiting foot pain for our younger patients and improving gait.

bunion splint
A bunion splint can be helpful in children.
Image Source: BunionAdvisor.com

Does My Child Need Bunion Surgery?

Surgery is only considered in rare instances in which the child is suffering from severe, chronic pain. Bunion removal is not done for cosmetic reasons alone. Ideally, you should wait until age 13-15 for girls or 15-17 for boys, when skeletal maturity is typically reached.  The American Academy of Orthopedic Surgeons warns that a childhood bunion can return if surgery is performed too soon, before he or she is fully grown.

Surgery involves surgically breaking the bone and rearranging cartilage. Recovery generally consists of six weeks of non-weight-bearing (usually in a cast), followed by four weeks of full weight bearing in a tennis shoe. Complications are rare but may include chronic inflammation, infection, scarring, recurrence of bunions, and persistence of bunion pain.

As The Huffington Post suggests, bunion surgery can be problematic in children, because they are still growing, and surgeons must be careful to avoid the epiphyseal plate so the bones can continue to develop normally.

Receive an Expert Opinion

An expert’s diagnosis is needed before proceeding with treatment. One mother was sure her child had a bunion, but it turned out to be a similar-looking deformity called Fibrodysplasia Ossificans Progressiva, which requires a different type of treatment.

There are numerous bunion removal procedures to consider. It’s important that you find a trusted expert in bunionectomy if your child is suffering impairment of everyday activities as a result of a foot deformity. Contact one of our NY podiatrists to discuss surgical and nonsurgical options for your child.

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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.