Tailor’s Bunion (Bunionette)
What Is a Tailor’s Bunion?
Tailor’s bunion, also described as a bunionette, is a bony prominence of the fifth metatarsal bone at the base of the little toe. Tailor’s bunions are not as common as bunions, which occur on the inside of the foot at the big toe joint, but they are similar in symptoms and causes.
The deformity received its name centuries ago, when tailors sat cross-legged all day with the outside edge of their feet rubbing on the ground. This constant rubbing led to a painful bump at the base of the little toe.
Tailors’ bunions are predominently caused by an inherited faulty mechanical structure of the foot resulting in changes to the structure of the bony framework of the foot with the fifth toe bone protruding outward, while the little toe moves inward. This shift creates a bump on the outside of the foot that becomes irritated whenever a shoe presses against it.
Sometimes a tailor’s bunion is actually a bony spur (an outgrowth of bone) on the side of the fifth metatarsal head.
Regardless of the cause, the symptoms of a tailor’s bunion are usually aggravated by wearing shoes that are too narrow in the toe, producing constant rubbing and pressure.
The symptoms of tailor’s bunions include redness, swelling and pain at the site of the enlargement. These symptoms occur when wearing shoes that rub against the enlargement, irritating the soft tissues underneath the skin and producing inflammation.
Tailor’s bunion is easily diagnosed because the protrusion can be seen. X-rays may be ordered (but not necessary).
Treatment typically begins with nonsurgical therapies with one or more of the following:
• Shoe modifications. Choose shoes that have a wide toe box, and avoid those with pointed toes or high heels.
• Padding. Bunionette pads placed over the area may help reduce pain.
• Oral medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may help relieve the pain and inflammation.
• Icing. An ice pack may be applied to reduce pain and inflammation. Wrap the pack in a thin towel rather than placing ice directly on your skin.
• Injection therapy. Injections of corticosteroid may be used to treat the inflamed tissue around the joint.
• Orthotic devices. In some cases, custom orthotic devices may be provided, especially in sporty/active people.
When Is Surgery Needed?
Surgery is normally avoided; however it is considered when pain continues despite the above approaches. In selecting the required procedure or combination of procedures the foot and ankle surgeon will take many factors into consideration such as the extent of your deformity based on the x-ray findings, your age, your activity level. The length of the recovery period will vary, depending on the procedure or procedures performed.