The Center for Podiatric Care and Sports Medicine

Bunion Surgery: Is It Necessary for Your Teen?

Posted by on Friday, September 4th, 2015

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No parent wants to see a child suffer with a physical abnormality, but is bunion surgery really necessary?

Bunions are shifted metatarsal bones that cause the joints of the big or little toes to prominently stick outward and press up against the shoe. They are largely hereditary in nature, but can be exacerbated by improper foot support. Often, bunions are seen in people with tight calf muscles and arch instability. It’s an old myth that only “old ladies” get bunions; in fact, up to 30% of adolescents are affected by the condition.

Being a young person with a bunion is psychologically difficult due to the pressures put on those who are deemed “different” in any way. Furthermore, it’s difficult to find shoes that fit well. The constant rubbing and irritation can cause chronic pain, which is usually what brings people to see the NYC podiatrists at The Center for Podiatric Care and Sports Medicine in Manhattan or Westchester.

teen bunion surgery
Bunions are inconvenient for young fashionistas, but podiatric surgeons only recommend surgery when pain and limited mobility become an issue. Image Source: Flickr CC user Maegan Tintari

What Can Be Done About Teen Bunions?

There are many non-invasive treatments a podiatrist may employ to prevent the worsening of a bunion. If caught early, many teens go on to lead productive, enjoyable lives — pain-free. Footwear counseling, bunion pads, taping, and splinting can go a long way in preventing future problems. When bunions are more severe, we can administer cortisone injections and ultrasound therapy for pain and then address functionality issues with physical therapy and corrective orthotics that fit inside the shoes.

Should Bunions Be Removed?

The only way to remove the unsightly bump is to undergo bunion correction surgery. Yet, the decision to operate on a juvenile bunion is never an easy one. A new systematic review covering nine studies and 140 teenage patients with bunions published in the Journal of Children’s Orthopaedics sheds some light on the subject.1http://www.hcplive.com/medical-news/bunions-in-teens-surgery-vs-conservative-approach Most subjects were female (as girls with bunions outnumber boys 10 to 1) with a mean bunion surgery age of 14.5 years and were followed for an average of 42 months.

Researchers found that 86% of teens with bunions removed were “satisfied” or “very satisfied” with the outcomes of their bunion surgeries. Clinically speaking, doctors were satisfied with 90% of cases. The radiological angles of the bunions all showed improvement, although they were not always corrected within the “normal range.”

Complications occurred 22% of the time, which was lower than previously reported numbers. Problems included “sub-optimal correction, excessive first metatarsal shortening, inadequate fixation and non-union.” Recurrence within 3.5 years was 8%, with study authors conceding this number could increase as the years pass. They added that “further studies are needed to examine if delaying surgery until skeletal maturity is advantageous and has better outcomes.”

Factors To Consider

The high satisfaction rate in the clinical review makes bunion surgery for teens seem like a no-brainer, but there are several points to consider before pushing for the operation.

1. Does the bunion hurt or diminish the quality of life? The chief factor we consider in opting for surgery is whether or not the bunion is truly interfering with a patient’s day-to-day life. Yes, it can limit shoe choices for prom come spring, but does it hurt after hours or standing or participating in physical activity? Does the bunion rub and irritate, despite a change in footwear?

2. Is the bunion worsening, even with treatment? For most cases, six months of conventional therapy is typically recommended before the surgery topic comes up. We take diagnostic imaging to assess the extent of the deformity and monitor for signs of worsening. We are not cosmetic surgeons or in the vanity business. Our practice corrects deformities that limit motion and cause pain.

3. How sensitive is your teen? Most operations are performed under local ankle block anesthesia, so the patient does not feel a thing. However, the patient is awake and generally aware during the surgery, though we can use mild IV sedation to relax the patient as best we can.

4. Can your teen afford time to recover?  Procedures, bunion severity, and individual healing times vary, but the average patient takes about six to 12 weeks to recover, which includes time spent on crutches and in a special walking boot.

5. Can you afford it? The Center for Podiatric Care and Sports Medicine accepts most major insurance plans. While insurance does not always cover the cost of bunion surgery, there are many cases where they will. All told, most bunions can be removed for less than $5,000. Our friendly office staff will do their best to ensure that the care your teen receives is as affordable as possible.

NYC Bunion Treatment

There are more than 100 different procedures to correct bunions.2http://orthoinfo.aaos.org/topic.cfm?topic=a00140 Expert surgeons at The Center for Podiatric Care and Sports Medicine are adept at many types of bunion surgery to provide your teen with personalized care. Our podiatric specialists will work with you and your teenager to find the best possible solution. Contact us to set up an appointment.

 

 

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1. http://www.hcplive.com/medical-news/bunions-in-teens-surgery-vs-conservative-approach
2. http://orthoinfo.aaos.org/topic.cfm?topic=a00140

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.