Bunions can run in families and be uncomfortable for children, particularly those who are very active.

Overview

What are bunions?

Hallux Valgus is more commonly known as a bunion. While many people think this is something that occurs just in adults, it can actually be seen in children. It is a bump on the inside of the foot at the base of the big toe.

Cause

There is no known reason why children have bunions, but there may be a family history of bunions.

Symptoms

The bunion is likely to be visible and causing discomfort or pain for the child. This is usually activity related, so if the child does a lot of running or walking, and it is also likely to be worse in certain footwear.

While adults may experience joint pain and stiffness, this is fairly uncommon in children and teenagers but may develop later in life if the bunion goes untreated.

Treatment

Investigations

To investigate the cause of the bunion, a physical examination will be carried out and it would be helpful to provide a detailed family history. To assess how severe the bunion might be,  x-rays will be done to show the full picture.

Lifestyle changes

There are certain non-operative measures that you can do for your child to try to relieve the symptoms. These include insoles, splinting and reducing the physical activity your child does. The most important factor that can help is to assess what shoes your child wears and changing these if appropriate. Shoes that have a wide toe box and low or flat heels are the best choice.

Surgery

Where the more conservative and non-surgical approaches have not helped and the bunion remains and continues to cause discomfort, surgery may be required. This is usually reserved for children who are nearly fully grown and who are in pain as a result of the bunion.

The operation is performed through small incisions in the skin, known as minimally invasive surgery. This approach speeds up recovery.

As with any surgery, there may be some complications and these include over-correction, under-correction or recurrence.

Helpful resources

• Adolescent hallux valgus: a systematic review of outcomes following surgery: J Child Orthop. 2015 Apr; 9(2): 105–112.
  Published online 2015 Apr 22. doi: 10.1007/s11832-015-0655-y