Bunionette (Tailor’s Bunion) Overview
The term tailor’s bunion comes from the position of a tailor sitting in a cross-legged position. Bunionette form when the fifth toe (smallest toe) moves out of alignment and towards the fourth toe, usually there is an bony enlargement of the fifth metatarsophalangeal joint. Friction between the bony prominence and shoe gear can cause discomfort and develop callus, inflammation and pain. Over time, the movement of the fifth toe can lead to irritation of other toes which may cause deformity of other toes such as hammertoes and deviations of toes. Females are three times more like
Causes of a Bunionette
Bunionettes can be caused by:
- Friction and irritation from tight fitting shoes
- Increased separation between the fourth and fifth metatarsals
- Enlarged fifth metatarsal head
- Lateral deviation of the fifth metatarsal
- Bursa (fluid filled sack) formation over the area
- Trauma to the area
Symptoms of a Bunionette
Many people with bunionette suffer from discomfort and pain from the constant irritation, rubbing and friction of the enlargement against shoes gear. The skin over the toe becomes red, tender, achy and uncomfortable to wear shoes. Over time corn, callus, bursitis and arthritis may develop.
- X-ray: May be needed to determine the size, severity of the deformity and to determine if there is any arthritis.
Conservative Treatments of a Bunionette
The goal for bunionette treatment is twofold: first, to relieve the pressure and pain cause by irritations, and second to stop any progressive growth of the enlargement. Commonly used methods for reducing pressure and pain caused by bunionette includes:
- The use of protective padding, often made from felt material, to eliminate the friction against shoes and help alleviate inflammation and skin problems.
- Removal of corns and calluses on the foot.
- Changing to carefully-fitted / wider footwear designed to accommodate the bunionette and not contribute toward its growth.
- Orthotic devices—both over the counter and custom made—to help stabilize the joint and place the foot in the correct position for walking and standing.
- Exercises to maintain joint mobility and prevent stiffness or arthritis.
- Toe Splints for nighttime wear to help the toes and joint align properly. This is often recommended for pediatric and adolescents with bunionette, because their bone development may still be adaptable.
- Topical pain relieving gel
Surgical Treatment of a Bunionette
Depending on the size of the enlargement of the bunionette, malalignment of the fifth toe and amount of pain experienced, conservative treatments may not be adequate to prevent progressive damage from bunionette. In these cases, bunionette surgery known as a tailor’s bunionectomy may be advised to remove the bunionette and realign the toe.