Juvenile Bunions

"Kiddie" Bunions

When we think of bunions we think of our mothers and mothers. However, bunions can affect, quite severely children and teens alike. For the most part children are without symptoms of pain as they are not subject to the degenerative changes seen in long standing adult deformities. A child’s first complaint is difficulty fitting into shoe gear. For many, cosmesis and feelings of self-consciousness are a concern at initial presentation.

Juvenile bunions are by definition more severe as the onset of the deformity is earlier and the progression faster and left untreated can lead to significant disability. Therefore juvenile bunions are treated aggressively to ensure the lowest rate of reoccurrence. At least 50% of juvenile bunions are associated with a flexible flat foot. Both the flattening appearance of the arch and the protruding big toe are secondary to hypermobility of multiple joints.


Juvenile bunions are more challenging to manage because children and teens are still growing and must be taken into account when directing a treatment plan. Girls growth plates tend to close be age 16 where as boys can take an additional year or so. Closing of the growth plates is what dictates when surgical intervention can be entertained.

Prior to surgical intervention there are a number of effective conservative options, which can be utilized with excellent results. Conservative options include custom orthotics, shoes gear modifications, padding, and anti inflammatory medications. Custom orthotics control excessive motion (hypermobility), which lead to the bunion deformity. Padding and shoe gear modifications are meant to relieve irritation and “bump pain” which can be a constant source of discomfort.

Regardless of age or symptoms children and teens with bunions can remain active and pain free with the help of a podiatric physician.