Tailor’s Bunion (Bunionette)

Tailor’s bunion is the shifting of the 5th metatarsal outward and the 5th toe inward. Tailor’s bunion is the enlargement of bone on the outside of the foot- 5thmetatarsal head. Tailor’s bunion is not as common as the bunion on the inside of the foot. The enlargement over the side of the bone may also have overlying soft tissue swelling called a bursa. If Tailor’s bunions are not treated they may probably increase over time.

Tailor’s bunion was named after the tailor who sat on the floor years ago performing their craft.

There are various causes of Tailor’s bunion; mechanical, congenital, metabolic, traumatic. Bunionette develops over time where foot type, foot biomechanics and rubbing play a role in the development. Shoes help promote development of the bunionette. Narrow pointed shoes in the forefoot and narrow high heel shoes can cause irritation from the pressure of the forefoot from the shoe.

The symptoms of the bunionette are pain, redness, swelling, irritation, numbness.

Diagnosis is through physical and biomechanical evaluation of the foot and xray. This helps in staging the amount of deformity.

Prevention and treatment;

Two options in prevention and treatment is conservative or surgical.

Conservative treatment

  • Shoes need a wide toe box, shoes can be modified/stretched over the bunionette. Avoid pointed narrow high heeled shoes.

  • Custom orthotics help in placing the feet in a more biomechanically efficient position to help slow the progression of the bunionette.

  • Bunionette pad to protect the bump and lessen the irritation and rubbing.

  • Ice, anti-inflammatories, injection can also be utilized.

Surgical treatment;

Patients may opt for surgery once they have tried all conservative options and the bunionette is still painful. The pain is either bump or joint pain. There are many possible risks and complications and extended post op course in having surgery so one should be able to accept the consequences if the surgery does not go well.

Treating the bunionette early on can help slow and possibly stop the progression and prevent further enlargement of the bunionette. Treatment options are based on symptoms and severity. Conservative treatment acts to possibly help relieve the pain, swelling and slow the progression of the bunionette. Surgical treatment makes the bunion go away, but there are risks and complications like re occurrence of the bunionette.