A tailor’s bunion, also known as tailor’s bunion or bunionette, is a bony prominence that appears on the lateral aspect of the 5th metatarsal head. The main symptom is local pain, which can vary from mild discomfort to intense pain.
In the foot, the metatarsals are the long bones that connect the ankle to the phalanges of the fingers. The metatarsals give balance and stability; and participate in the movements of the foot and fingers. There are 5 metatarsal bones, the first being the one that connects to the big toe and the fifth to the base of the little toe, on the outside of the foot.
A tailor’s bunion, also known as tailor’s bunion or bunionette, is a bony prominence that appears on the lateral aspect of the 5th metatarsal head. The metatarsal head is the end of the bone where it meets the 5th toe. It owes this name because in the past the tailors spent many hours sitting on the floor with their legs crossed with the outer face of their feet touching the ground. This rubbing caused a painful bump at the base of the little finger. A tailor’s bunion is much less common than the classic bunion, which affects the first metatarsal, on the inside of the foot.
What Are Your Causes
The most frequent cause is a mechanical defect in the structure of the bones of the foot, which causes lateral protuberance. Malalignment causes the 5th metatarsal to turn out and the 5th toe to turn in, and with it appears the bump at the base of the little finger that usually hurts.
These mechanical defects are often hereditary conditions (such as flat feet) or are a consequence of wearing narrow, sharp-toed, or high-heeled footwear. Indeed, narrow footwear always aggravates the symptoms of a tailor’s bunion, since it produces friction and pressure on the area, with the consequent inflammation of the soft tissues that surround the bone.
What Symptoms Does It Produce?
The main symptom is local pain, which can range from mild discomfort to intense pain. Without treatment, the discomfort progresses slowly over the years. If the deviation of the finger is very marked, it can cause gait disturbances. Although a tailor’s bunion does not endanger a person’s health, it can have a negative impact on quality of life.
The diagnosis is simple because, with the physical examination, the doctor observes the lateral protuberance and the deviation of the toe. X-rays may be taken to determine the severity of the situation.
The specialist doctor will always advise starting a conservative treatment. This treatment includes the following options:
- Wear wider, flat-heeled shoes.
- Use of silicone orthosis or pad in the area to avoid friction with the shoe.
- Use of specific templates.
- Lose weight if you are overweight.
- Application of local cold (ice pack), which always reduces inflammation and helps to improve pain.
- Oral anti-inflammatories in a timely manner or, occasionally, perform an infiltration with corticosteroids to reduce local inflammation.
- Calf stretches can be useful to avoid muscle contractures.
If pain and deformity limit the patient’s quality of life and do not improve with conservative measures, surgical treatment may be considered. This type of surgery is usually ambulatory (does not require hospital admission) and most of the time with local anesthesia.
There are different types of surgery depending on the particular characteristics of each patient and the severity of the situation. In milder cases, the bone protrusion that causes friction (condylectomy) can be filed down or removed, although this technique is less and less used. In most surgical cases an osteotomy is performed, which means cutting a part of the bone (5th metatarsal) to realign it. Currently, it is increasingly common for this surgery to be performed percutaneously, that is, as a minimally invasive surgery, which reduces complications (especially infections) and a faster recovery compared to classic open surgeries.
What you should know…
- The main symptom is local pain, which can vary from mild discomfort to intense pain. In the case of not starting treatment, the discomfort progresses slowly over the years.
- The specialist doctor will always advise starting conservative treatment: wider shoes with no heels; silicone orthosis or pad in the area to avoid friction with the shoe; specific templates; loss of weight; local cold…
- If pain and deformity limit the patient’s quality of life and do not improve with conservative measures, surgical treatment may be considered.