Video: Bunions in Children | Guide for Parents
Early Treatment of Bunions in Kids Can Prevent Problems Later in Life
Although bunions are much more common in adults, we do treat a surprising number of kids suffering with bunions. Bunions in children are not normal and should be treated. Our treatment goal is to prevent the bunions from getting larger and to eliminate any pain. If at all possible, bunion surgery on children should be avoided at least until the growth plates of the bones are fused. In fact, surgery should be your very last resort.
If you think your child might have bunions, contact us today for an appointment in our Seattle foot clinic. The earlier we start the treatment, the more likely it is we can avoid surgery.
A bunion deformity in a child is known as a Juvenile bunion. As with adult bunions, in a bunion in a child the joint at the base of the big toe (the metatarsophalangeal joint) moves at an angle toward the second toe. Juvenile bunions, however, are considered more serious as there are more years available for the bunion to get worse.
Why Do Children Get Bunions?
Shoes rarely play a role in causing bunions in children. Instead, juvenile bunions are usually related to heredity. Often they are secondary to “ligamentous laxity” (loose joints) and excessive pronation. When the child pronates excessively, it places too much pressure on the big toe joint, preventing normal function. Since the toe cannot bend up the way it should, the toe is forced to move to the side. If the child also has loose ligaments, a bunion can rapidly form.
If a parent or other close relative has bunions that bother them it is more likely that the child will have bunion problems also.
Treatment Goals for Juvenile Bunion
Our primary goal is to reduce the forces that are causing the bunion. This won’t reduce the bunion that has formed, but some studies indicate that it may help prevent the bunion from getting bigger. Non-surgical treatment includes the use orthotics that are specifically designed to prevent bunions, the use of wider shoes and shoe stretching. Be sure to bring some shoe samples with you to your appointment. Also, we will ask the child to avoid narrow dress shoes and high heels. Prefabricated or custom orthotics can also be very helpful, and may help slow growth of the bunion.
Orthotics to Prevent Bunions in Kids
There is a good amount of evidence that the use of certain types of orthotics can reduce or eliminate the joint forces that cause bunions. Orthotics won’t make bunions smaller but they usually help reduce pain and probably help prevent bunions from getting bigger. We will usually use a prefabricated or custom orthotic to help the big joint work better and prevent abnormal force on the joint. You can find detailed information here about orthotics for bunions. Orthotics will not reverse a bunion deformity, but there is evidence that that can help prevent it from getting bigger. They also work very well at reducing pain associated with bunions.
Surgery for Children’s Bunions
Once again we want to make clear that surgery should be a very last resort when treating bunions in kids. In fact, it is almost never necessary. Even if all conservative treatment is tried first, surgical correction of a bunion in a child is usually not recommended until growth of the bone is complete. Doing surgery before the growth plates have closed has potential to damage the growth plates.
In kids who do not respond to non-surgical treatment, however, and who have pain that interferes with their daily activities, surgery to realign the bone and straighten the toe can be done. There are a number of different approaches to bunion surgery in children and the exact procedure would depend on the type and size of the bunion, the age of the child, and how much growth remains.
If your child has a bunion, contact us today for an appointment in our Seattle foot clinic.