A bunion is a deformity that podiatrists call hallux abductovalgus. The name describes the deformity; hallux is the name for the big toe and abductovalgus means that the big toe is moving away from the center of the body. When most people think about bunions, the first picture that comes to mind is the elderly woman who wore high heels most of her life and now has a large bump on the side of her big toe. Bunions are more frequent in women than men possibly due to their choice of shoes. However, children can also experience bunions!

For children, the type of bunion is classified by the age that the bunion develops. The four classifications are:

  1. Congenital hallux abductovalgus: The child is born with the bunion.
  2. Infantile hallux abductovalgus: The bunion develops before the child reaches 2 years old.
  3. Juvenile hallux abductovalgus: The bunion develops between the age of 2 years old and early teen years.
  4. Adolescent hallux abductovalgus: The bunion develops during the mid teen years and early 20’s.

Even though there is a clear classification system for bunions, it is difficult to place the bunion into the correct class because the bunion may go unnoticed for several years, especially if the child does not experience any pain. If a bunion is noticed in a baby, infant, child or adolescent, it is important to bring them to a podiatrist right away for treatment. There are several ways of treating bunions, in children, with the most ideal being a non-operative therapy. A non-operative therapy treatment plan will stop the bunion from worsening as well as trying to eliminate the bunion.  An example of a non-operative therapy is the use of orthoses; using orthoses in children to stop and get rid of the bunion has been effective, however, since orthoses are custom made, the devices are expensive and would need to be remade often since the child’s feet will grow out of the orthoses with age. Another treatment option is having the child wear a splint at night to straighten the toe out; this has been shown to improve the juvenile and adolescent abductovalgus deformities.

As a last resort, surgery can be done to fix a bunion; however, if the surgery does fix the bunion, the bunion may reappear later in life. Surgery should only be considered in the cases of juvenile and adolescent hallux abductovalgus that were not able to be treated by non-operative therapies. The only time a surgery may be needed in the congenital and infantile hallux abductovalgus cases is if the baby or infant has a lot of pain and get no relief from the non-operative treatments.

Babies and children have cute tiny feet, but if a bunion is noticed or their big toe does not look normal, take them to a podiatrist so they can get treatment early on to stop and fix the deformity before it is too late.

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