Does my Child Need Bunion Surgery?

Foot pain? We typically don’t associate foot pain with children, but there are a number of foot conditions that cause pain in our young offspring. Our kids can have bunions too! Yes, I know we all think of bunions as a nasty bump that woman get after years of wearing bad shoes. However, shoes are not the primary cause of bunions. There is always an underlining biomechanical problem that is causing the common foot deformity. This deformity is genetic in nature. Shoes will often progress or aggravate the underling disorder. In a few unlucky individuals, the biomechanical imbalance is so severe that they have a bunion at a very young age. Now, what do we do for a child with a big, bad bunion?




First, how painful is the bunion? Yes bunions are ugly, but they are not always painful. Often, we see this deformity and assume it must be the most uncomfortable thing in the world. Frequently, the bump looks worse than it feels. Children are young and resilient and most likely have very healthy joints and cartilage. Adults have years of wear and tear on their joint and some degree of associated arthritis with the bunion. Children are typically spared from joint pain; though, bunions are common among children with juvenile rheumatoid arthritis.

Second, are the child’s bones still growing? There are a number of surgical procedures to correct the deformity. These procedures rely on breaking the bone and resetting it with plates and screws. Growing children have open growth plates that would often interfere with these procedures. Every child is different, but the growth plate typically closes between the ages of 10-14 years old. Some procedures can be done without the disrupting the growth plate, but these procedures are not always the best option for correcting the deformity, thus surgical treatment is typically delayed until after the growth plates are closed.

There are no therapies that will turn back time on a bunion. It will not get better. It will only get worse. Surgery is not a treatment to jump into, but when severe deformities are present at a young age, more often than not, one will need surgery at some point in their life time. It is not recommended to have surgery if there is no pain associated with the deformity. Anybody with a bunion, even children, should take preventative measures to decrease the rate of progression of the deformity. Orthotics are always a crucial portion of the treatment plan both before and after surgery. Bunions, as mentioned, are caused by a biomechanical imbalance. Custom made orthotics gives your foot a functional advantage and decreases the deforming forces on the foot.

Bunions can be very unsightly for a child and a parent, but it is important to remember all of your treatment options. Conservative treatment always comes first. Many children are scared to undergo surgery and it is important to make sure they are prepared for the recovery time. Children are active and foot surgery takes some time to heal. Yet, many children stop participating in activities because of foot pain from bunions. That is unacceptable and treatable.