Bunions.  They are a very commonly seen foot deformity.  These deformities usually result after years of uncompensated muscular imbalances in the feet and ankles.  However, sometimes these deformities arise in children and even before their growth plates are closed.

Treating bunions depends on the severity, no matter what age one is.  Bunions in adults and children that are irritating simply because of difficulty in finding shoes can be treated by simple suggestions of appropriate shoe gear to allow enough room that the bunion does not continually rub on the inside of the shoe. 

Small bunions in adults are most often treated conservatively with the goal being to slow the progression as much as possible.  If a mild bunion is painful, treatments such as anti-inflammatories or even physical therapy may be necessary for a short period of time.  The best way to prevent a bunion from worsening is to use custom orthotics.  Orthotics help to rebalance the tendons in the ankle and foot to minimize compensation that can result in a bunion deformity.  If a 'small' bunion is still causing pain, surgery may be a reasonable treatment option.

Larger bunions can be painful in and of themselves, but the situation can become more complicated as the great toe starts to abut or underlap the adjacent toes on the same foot.  This can cause development of hammertoes.  Chronic severe bunions possess a risk of leading to arthritis in the great toe joint due the the malalignment, which places pressure and friction on the cartilage of the joint and can cause erosion of cartilage.  Depending upon the degree of deformity and the condition of the joint, bunions can be corrected while preserving motion in some cases and require fusion in others.

Bunions in kids are different, in that many adolescent bunions occur in feet with open growth plates.  The growth plates in the feet correlate with some of the typical locations for surgical bone cuts and therefore surgery is not typically recommended for adolescent bunions. 

In many children with adolescent bunions, there is instability in the joint in the middle of the foot that connects to the big toe.  Stabilizing this joint can be accomplished with custom orthotics.  However, orthotics are only effective when being worn and instability in the foot can still pose risk of worsening deformity if one chooses to wear unsupportive shoes.

If bunions in children prove to be painful despite conservative treatment, surgery can be performed, but is not recommended until the growth plates are healed.  Surgery may involve fusing the joint where instability lies to provide a more predictable and permanent solution and reduce the risk of recurrence.  Custom orthotics are always recommended after surgery, also to prevent recurrence.

If you or your spouse have bunions, your child will likely inherit this deformity if treatment is not sought early.  Make an appointment with our office today if you child has a bunion or if you are concerned they may end up with your bunion!  Our doctors will provide you with a thorough assessment and recommendations that you can trust!