Bunion Development in Young People


Bunions are generally associated with people older than 25 years of age and with good reason; this type of foot deformity is usually progressive and is the result of years of excessive pressures. Juvenile bunions are not unheard of however, and those afflicted usually range between 11 and 14 years of age. Children under the age of 10 are generally asymptomatic.
There is very little agreement concerning the etiology and treatment of bunions in the juvenile population. While some specialists insist that this condition is acquired in the formative years other specialists believe that this deformity occurs due to the malleable and unformed nature of bone tissues in people younger than 20 years old. And it is debatable whether juvenile bunions are merely a stage in the development of ‘adult’ bunion development or whether it is a separate condition that can lead to particular deformities in the developing foot bones of children and adolescents.


There are, in fact, several differences in the bunions typically found in juveniles when compared with adult deformities. Juveniles display less marked valgus rotation of the hallux, less incidence of arthritis in the first metatarsal joint, less incidence of chronic inflammation in the bursal sac, as well as a lesser bone growth at the metatarsophalangeal joint. Also, the younger the patient the more able they are to move the affected joint normally, free of the ‘freezing’ that is often found in older patients. There is little conclusive evidence as to why this is so, but the consistent nature of these differences would indicate that the condition is not identical in juveniles and adults.


While it isn’t clear what exactly causes juvenile bunions to develop it is clear that all hallux valgus deformities are the result of inferior mechanical functioning in the metatarsophalangeal joint of the big toe, and any other issue found to cause pronation and instability in the first ray of the foot will only add to the problem. These other issues may include metatarsus adductus, congenital deformities, pes valgus (rocker bottom foot), obesity, immobile ankle joints, and/or muscular imbalances, all of which can cause uneven pressure points in the feet and toes.


Dealing with bunion development in juveniles may become as much of an emotional issue as it is a physical one as this particular age group is often extremely sensitive to perceived criticism or looking different from their peers. While they may not wish to appear different by having a ‘deformity’ such as hallux valgus, they may not wish to appear different by avoiding the type of footwear or activities that amplify the problem as well. Care should be taken to be sensitive over this issue, even if the deformity is minor.
More troubling for many adults is the possibility that a child’s level or choice of activity may be limited by this affliction. While it isn’t typical for this age group reduced activity levels and difficulty finding well-fitted, appropriate footwear may be an issue. Bunions development in juveniles should be examined by a podiatrist who specializes in children’s feet, particularly if there are issues concerning physical activity, shoe fittings, or the use of orthotic devices.

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