ADOLESCENT BUNION
If your child has a bunion, he or he could be wearing shoes that are either too tight, have a narrow toe, or have a heel on them. While wearing heels does not cause bunions, it can make symptoms appear sooner. Shoes can also be the cause of other foot issues such as corns, calluses, and hammer toes.
If your child needs surgery or casting, our Fracture Care Clinic opens every day and you do not need an appointment. Surgery rooms get scheduled every morning, so your child receives the care and attention they need right away.
Identification of an Adolescent Bunion
A bunion is an uncomfortable bony growth that develops near the big toe joint on the inside of the foot. A juvenile hailux develops during childhood. Adults get bunions because of extra bone growth, which causes inflammation. The cause is different in children. Bunions in young people and teenagers are caused by a misalignment of the big toe, which is a structural issue that causes the bones of the foot to point inward and move the cartilage of the big toe over the smaller toes, resulting in the formation of a bunion.
What is a Bunion?
A bunion is a bony bump on the big toe. It occurs when the joint that connects the toe to the foot swells and protrudes. Bunions are most commonly found in both feet of children. The majority of bunions do not require treatment. However, on the other hand, some enlarge over time, causing the big toe to angle in toward the second toe and making wearing any type of shoe painful. This can result in shoe rubbing and irritation of the skin and tissue overlying the bone.
The big toe’s pressure can push the second toe out of alignment, causing it to overlap with the third toe. While bunions are most common in adult women, they can also occur in tweens and teens aged 10 to 15, Bunions are three times more common in teenage girls than in boys.
Adolescent Bunion
Other types of bunions exist in addition to the common ones. Adolescent bunions are, as the names indicate, bunions that occur in young people. These bunions are most common in young girls aged 10 – 15. While an adult’s bunion usually limits motion in the MTP joint, a young person with a bunion can usually move the big toe up and down. However, an adolescent bunion can still be painful and make wearing shoes difficult,
Bunionette
A bunionette, also known as a Tailor’s Bunion, is a condition that occurs on the outside of the foot near the base of the little toe. A bunionette is similar to a bunion, although in a different location on the foot. You can have a tough corn or callus above the lump in addition to painful bursitis.
QUESTIONS AND ANSWERS
Will my child’s bunion get worse as they grow
Yes, in many cases, bunions in children can progress as they grow, especially if the underlying cause is biomechanical, such as flat feet, hypermobility, or genetic predisposition. Since the bones in children are still developing, abnormal alignment and joint pressures can gradually worsen the deformity. Early detection and conservative treatment can help slow the progression, but ongoing monitoring is key.
Can my child’s bunion be treated without surgery?
Yes, most pediatric bunions can initially be managed with non-surgical treatment. This may include:
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Wearing wider, supportive shoes to reduce pressure on the bunion.
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Using custom orthotics to improve foot alignment and reduce stress.
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Performing stretching and strengthening exercises to improve joint stability.
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Applying ice and anti-inflammatory medication if pain or swelling occurs.
However, these treatments don’t reverse the bunion—they aim to reduce symptoms and slow the deformity’s progression. Surgery is considered only if pain persists or the bunion severely interferes with daily activities, and typically not until skeletal maturity.
Will my child need surgery, and if so, when is the best time?
Surgery is usually a last resort for pediatric bunions. It’s considered only if:
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The bunion is painful and limiting the child’s activity.
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There’s no improvement with conservative measures.
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The deformity is rapidly progressing or causing other foot problems.
If surgery is needed, we typically wait until the bones have finished growing, which is usually around age 13–15 for girls and 15–17 for boys, to reduce the risk of recurrence. The specific surgical procedure depends on the severity of the bunion and the child’s foot anatomy.
The Medical City Children’s Orthopedics and Spine Specialist doctors are experts in treating children with Scoliosis. We have decades of experience and urge parents to bring their children in for an examination.
Adolescent Bunion Causes
Bunions are frequently an inherited family trait in adolescents. Certain medical conditions, such as Cerebral Palsy and Down syndrome, increase a child’s risk of developing bunions. There are numerous theories about how bunions form, but the precise cause is unknown. Factors are likely to include”
- Foot type is inherited
- Foot strain or injury
- Deformities that exist at birth
Experts disagree on whether tight, high-heeled, or too-narrow shoes cause bunions or merely contribute to their development. Bunions may be linked to certain types of arthritis, particularly inflammatory ones like rheumatoid arthritis.
Adolescent Bunion Symptoms
The severity of adolescent bunions affects the symptoms. While the majority of bunions are not painful, symptoms may include:
- a bony projection at the foot of the big toe joint
- swelling or soreness at the base of the big toe
- Having trouble finding shoes that fit
- Discomfort when walking or playing sports
- The feeling of burning
- Flat feet or pronated feet
- Hypermobility of joints (loose ligaments, floppy joints)
Bunion symptoms can be confused with those of other medical conditions or problems. Always seek a diagnosis from a pediatric orthopedic doctor like those in our practice
Diagnosing an Adolescent Bunion
Make an appointment with our office, and if your child or adolescent is experiencing bunion symptoms, we will provide the best advice and treatment needed by using the following tools:
A physician examination
The doctor will look for things like proper foot alignment, walking alignment, weight-bearing alignment, and how the affected joint moves during the exam
Imaging tests
To determine the severity of the condition, our orthopedist may order tests such as an X-ray and a CT scan.
Blood tests
We may order blood tests to check whether another condition contributed to the bunion. The doctor will also want to know what shoes your child wears and which shoes aggravate his or her symptoms. The doctors will try to determine whether the bunion is causing any pain and whether the bunion is causing any functional limitations. Additionally, the doctors will determine if other conditions that are similar to bunions exist. For instance, arthritis, hammer toe, bursitis, and joint infection can also occur and cause symptoms similar to a bunion. During the examination, our doctors would rule out these other conditions.
Non-Surgical Treatment Options
Properly fitting footwear
Shoes with enough space inside for the toes can relieve pressure. A good shoe store will measure your child’s feet and advise the parents on the appropriate footwear options. Also known as orthotics, inserts relieve toe pressure. Toe paddling, taping, or splinting can provide support and reduce irritation.
Avoiding activities that cause pain
Stop standing for long periods of time or engaging in contact sports
Physical Therapy
Treatments such as ultrasound therapy, whirlpool therapy, massage, and heat therapy can provide relief from bunion pain.
Ice
Applying ice to the affected area can aid in the reduction of swelling
Medication
Medication is effective in reducing pain and swelling. Many over-the-counter drugs are available
Cortisone Injections
These can help to reduce swelling, especially in the fluid-filled pads that cushion the bones. Your doctor can provide more information and guidance on this therapy.
Adolescent Bunion Surgical Treatment Options
Surgery is not advised for teenagers with bunions unless they have previously replaced ill-fitting shoes, are using an orthotic, or both. If they continue to experience severe foot pain that limits their daily activities, surgery may be an option. The purpose of surgery is to relieve pain and correct deformities. Surgery for purely cosmetic reasons is not advised. Some bunions may necessarily require surgery. When bunions require surgery, several options are available. The following situations may require surgical recommendations:
- Suffering from pain and inflammation that does not respond to other treatments
- Have a severe enough deformity that the toe may cross over another toe
- Due to stiffness, the child cannot bend or straighten a toe
Younger people with bunions rarely require bunion surgery. A full recovery from surgery can take up to 6 months. Regular doctor appointments may be required. The goal of surgery is to alleviate pain, realign the metatarsophalangeal (MTP) joint, and correct any deformities that are causing the problem.
Repairing the tendons and ligaments
This procedure involves cutting any weak joint tissues and lengthening the toe. Tendon and ligament repair are frequently performed concurrently with osteotomies
Osteotomy
This is a procedure for realigning the joint. To repair the bone, doctors use pins, screws, or plates.
Bunion surgery with minimal severity
The bone is cut and repositioned in this procedure, which is similar to traditional bunion correction. However, the incisions are much smaller, and patients usually recover faster.
Arthrodesis
The swollen joint surface is removed during this procedure. The surgeon will then insert screws, wires, or plates to keep the joint together while it heals. This procedure is typically used to help people who have severe bunions, arthritis, or who have had unsuccessful bunion surgery.
Exostectomy
The bump on the toe joint is removed by the surgeon. This surgery is frequently performed in combination with an osteotomy. Exostectomy usually does not treat the underlying cause of the bunion.
Arthroplasty with Resection
This procedure removes the damaged portion of the toe joint, allowing for more space between the toe bones. Surgeons use this procedure for the following:
- Those who had a bunion surgery that did not resolve the issue
- Those suffering from severe arthritis and unable to undergo arthrodesis
Risk Factors and Complications
Bunions, if left untreated, can make it difficult to wear shoes or walk without pain. Untreated bunions can also cause loss of movement in the big toe, arthritis, and toe joint bursitis. Bunions usually respond well to early, conservative treatment, which is why children should see a doctor if they have bunion symptoms. Based on the severity of the bunion, your doctor can recommend the best treatment. Bunions are prone to the following risk factors:
- Bunions run in the family
- Inadequate or ill-fitting footwear that squeezes the toes
- Joint inflammation caused by conditions like psoriatic arthritis or rheumatoid arthritis
- Neuromuscular disorders such as Marfan syndrome
- Foot mechanics issues, such as overpronation (when the foot rolls inward too much when striding)
- Avoiding wearing high heels
- Connecting gait abnormalities caused by conditions such as flat feet or pronation
- Wearing shoes with a wide toe box and properly fitted
Why Choose the Medical City Children’s Orthopedic and Spine Specialists
Because bunion symptoms are similar to those of other foot conditions, take the advice of our expert pediatric orthopedists for an accurate diagnosis of any foot problem. Finally, the team at the Medical City Children’s Orthopedic and Spine Specialists have offices in Dallas, Arlington, Flower Mound, Frisco, and McKinney, TX. We specialize in children and ensure your child receives the very best care possible.
If you are looking for a top-rated pediatric orthopedic surgeon in the Dallas and Fort Worth area to treat your child’s union, Medical City Children’s Orthopedics and Spine Specialists is a great option. With their expertise, compassion, technology, and convenience, they can help your child get the care they need to get back in their normal activities. Our doctors stand ready to speak with you about the many ways to treat a bunion. So, call us today at (214) 556-0590 to schedule an appointment.
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Footnote:
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Comprehensive services for children from birth through adolescence at five convenient locations: Arlington, Dallas, Flower Mound, Frisco and McKinney.