Early Foot Deformity
Some children develop foot deformities often assumed to be found only in older adults. The fact is, these very same deformities can develop early in childhood. Some of the more common deformities occurring in this category are bunions and hammertoes.
Bunions are common deformities involving the big toe that typically develop over the course of many years. The big toe pushes towards the toe next to it, and there is an enlargement on the inner side of the foot at the base of the toe. This deformity can appear early on during growth and development, especially if there is excessive mobility of some of the bones in the feet contributing to the bunion. The instability hastens the development of the bunion, and children who have early bunions often have more severe deformities than adults who develop it later on. Bunions can be very painful, and often require surgery for correction. Not all bunions are painful, however, and consideration for surgical correction is usually delayed until the bones have stopped growing, unless there is notable pain and activity limitation as a result of the deformity. Orthotic shoe inserts can be used to limit the excessive mobility, and help reduce the gradual progression of this deformity.
Hammertoes appear likewise in many people gradually through adulthood or early on in childhood. Hammertoes develop due to an imbalance between tendons that flex the toe up and down. This can occur often with flat feet and high arches. In adults, these can be painful from shoe irritation or rubbing in between the toes. Hammertoes are frequently seen but rarely painful in children, unless the toes rotate or cross over one another. Deeper shoes often help with discomfort. Surgery is reserved for severe cases, or for deformities that interfere with shoe fit. Again, orthotic inserts can be used to reduce the gradual progression of these deformities in adulthood.