Bunion Deformity (Juvenile Hallux Valgus)

Bunions can occur in children and adults. Juvenile hallux valgus is the name for a bunion that develops during childhood. A bunion is the development of a large bump on the inside of the foot where the great toe meets the end of the foot. The great toe may look like it's growing towards the small toes.

What Causes Hallux Valgus?

No one knows for sure exactly why juvenile hallux valgus occurs. This disorder tends to run in families. Young people with flat feet are more likely to have a bunion deformity. Tight, poorly fitting shoes also predispose to the development of juvenile hallux valgus. Children with an underlying neurologic (brain or nerve) problem are more likely to develop this condition as well.

What Are the Signs and Symptoms of Hallux Valgus?

Juvenile hallux valgus causes a bump on the inside of the foot at the base of the great toe. Some children are very sore at the site of this bump. Individuals with bunion deformities often find tight shoes irritating. Juvenile hallux valgus sometimes causes pain with walking.

How Is Hallux Valgus Diagnosed?

Usually, your physician will be able to diagnose juvenile hallux valgus with a physical exam. X-rays of the foot help determine how severe the deformity is.

What Is the Treatment for Hallux Valgus?

For many types of foot deformities, physicians recommend early correction so affected children won't have difficulties with activities in the future. The treatment of bunions is different. Physicians recommend trying non-surgical methods to help the symptoms. Children and teens with bunions should wear shoes with a wide toe box and low heels so they don't put too much pressure on the bump or make the condition worse. Customized shoe inserts may help position the foot better inside the shoe, particularly in children with flat feet.

Surgery should only be considered as a last resort. Surgery is recommended only for children who have persistent, significant pain which gets in the way of activities, even after trying non-surgical treatment. There are several surgical procedures used to correct this deformity; much of the surgical decision making depends on how the foot looks on physical exam and x-ray. Surgery for non-painful bunions, solely to change the appearance of the foot, is not recommended.

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