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Tailors Bunion (Bunionette) Correction

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What is a tailor’s bunion? 

Also referred to as a bunionette, is a bony lump that forms along the side of the smallest toe. This occurs when the fifth metatarsal bone swells up or shifts outward. The fifth metatarsal is the very bottom bone on the little toe. A bunion in this area can be painful, especially if it rubs against your shoe. 

Causes: This type of bunion stems from wearing ill-fitted shoes, such as narrow, high-heeled shoes. The issue can also be genetical, because there’s a possibility you’ve inherited a structural foot problem from your parents. This problem could be that the bone in your little toe is in an abnormal position or the head of the bone is swollen, which causes the bone to move out of place.

Other causes include:

  • a foot that leans to the outside (inverted foot)
  • loose ligaments in your foot
  • lower-than-normal fifth metatarsal bone
  • tight calf muscles

It’s common for tailor’s bunions to occur when you’re young as it gradually gets worse with time. By the time you reach your 40’s, the bunion can start causing pain.

Sign & Symptoms: A tailor’s bunion is the swelling of the outside area of your smallest toe and can also be red and painful.  The bump might start out small with potential to grow larger with time. Bunions may get more swollen and painful when it rubs against your shoe.

You can get this type of bunion on one or both feet. The bunion on one foot may be worse than the one on the other foot.

Diagnosis and Treatment: Podiatrists should be able to diagnose tailor’s bunion just by looking at your foot. If necessary, an X-ray can identify issues with the bone of your little toe.

To help reduce swelling, you may need to receive injections of a corticosteroid around your little toe’s joint. Your doctor might also recommend a custom-designed shoe insert to cushion the bunion and prevent pain. If the pain and swelling persist, or if you can’t wear normal shoes because the tailor’s bunion has grown so large, surgery may be an option.

Because bunionette surgery is an outpatient procedure, you are discharged on the same day as your surgery. The surgeon will give you anesthesia to prevent pain and then shave off the tissue that is sticking out. Your surgeon might also perform a procedure is called an osteotomy, which is when they remove part of the bone in your little toe to straighten out the toe, and then the bone will be held in place with a screw, plate, or piece of steel wire.

Recovery: After bunionette surgery, you need to keep weight off the affected foot. You will probably need to utilize crutches or a walker to get around, or have to wear a splint or boot for 3 to 12 weeks to protect your foot while it heals. You’ll have to stay home from work for a few weeks, especially if your job involves a lot of walking. Nonsurgical treatments can often resolve bunion symptoms within 3 to 6 months. After surgery, full recovery can take up to three months. Swelling in the affected toe might take as long as a year to return to normal. Physical therapy is also an option, as foot and ankle exercises after surgery can help keep your joints flexible while you heal.

Dr. Ray Lopez

Minimally Invasive Bunion Surgery