This is a great example of how poor biomechanics impacts foot pathology. This is a case of juvenile bunions with flat feet that has recently been presented in my rooms. I have successfully corrected the mother’s bunions and she is now showing concern for her daughter’s painful feet. Pain in the long medial arch and 1st metatarsophalangeal joint (MTPJ).
Note how flat the feet are on the top images, however, actively raising the arch allows for a marked decrease in the excess pronation and less prominence of the bunions as seen on the lower images. This is a fine example of how pes planus can lead to foot pathology such as bunions (it must be remembered that genetics is still the main cause of bunions).
She has been referred for orthotics that should control her symptoms. If pain and deformity continue then she would be a good candidate for modern bunion surgery and Hyprocure. The aim is to put this off until she is in her late teens unless the pain and deformity is too marked and does not respond to the orthotics.
If you have any specific questions or would like to discuss similar cases, please contact me.
Also read:
Juvenile hallux valgus (bunion)
Adult-acquired flat foot (PTTD)
The problems with keyhole bunion surgery
Improvements in bunion surgery
Post-operative pes planus/flat feet/excess pronation
Pes planus
Accessory navicular with pes planus
Hyperpronation cure
Bunion surgery: Modern procedures for quick recuperation and long-term results
(This content is intended for healthcare professionals only)