Tailor’s bunion is another relatively common foot pathology that can be effectively treated with percutaneous or minimally invasive foot surgery.. We invite you to read on to learn about Tailor’s Bunionette, its causes, symptoms and definitive treatment.
What is tailor’s bunion?
Tailor’s bunion or Bunionette is a painful bony deformity in the lateral part of the foot, specifically in the fifth metatarsal joint (“
“. This bony protrusion is often painful and disabling in some patients.
Tailor’s bunion was first described in 1949 by H. Davies. Its name comes from the tailors of the time, who, when working with their legs crossed, exerted greater pressure on the lateral part of their feet, thus producing a hyperkeratosis or “hyperkeratosis”.
“on the head of the fifth metatarsal.
The pain produced by the tailor’s bunion is due to the pressure exerted by the footwear on the fifth joint, specifically the metatarsal head. This constant pressure causes bursitis or ” bursitis “.
“which can lead to infection.
Tailor’s bunion is more frequent in women, with a ratio of 2:1.
Patients often ask why this painful foot deformity occurs.
This specific pathology is not as frequent as the bunion that affects the first toe, but they are similar in terms of symptoms and causes.
Causes of tailor’s bunion?
The origin of the tailor’s bunion is due to several factors. They can be mainly grouped into: congenital, structural and biomechanical causes, systemic, traumatic and iatrogenic diseases.
Structural and biomechanical causes include excessive subtalar joint pronation, varus feet, plantar flexion of the fifth metatarsal, or a shorter or more prominent fifth metatarsal. Also, tight footwear compresses the fifth toe joint causing pain. Finally, the supernumerary bones of the fourth metatarsal may push laterally on the fifth metatarsal.
The fifth metatarsal of the foot is the most flexible and is the main cause of tailor’s bunion.
Pronation of the foot due to congenital hyperflexibility can lead to bunion formation. Other causes may include inflammatory diseases such as rheumatoid and gouty arthritis that produce abnormal pronation of the foot as well as trauma and iatrogenesis from previous surgeries.
Clinical presentation of tailor’s bunion
The main symptom is soft tissue inflammation at the head of the fifth metatarsal (fifth toe joint) that produces pain on the lateral aspect, especially with tight shoes.
This continuous pressure produces a chronic irritation of the bone that manifests itself in callosity or hyperkeratosis, bursitis with edema and erythema (“
swelling and redness
“) which can eventually lead to ulceration and infection of the foot.
Tailor’s bunion classification
According to Fallat, the tailor’s bunion can be classified according to the type of deviation and the most appropriate treatment.
Type I, with a frequency of approximately 30%, is characterized by a protrusion of the fifth metatarsal. II is observed in 20% and is defined by lateral deviation of the fifth metatarsal without bony protrusion. Type III is characterized by an increase in the intermetatarsal angle and is the most frequent (50%). Finally, type IV is a combination of two or more of the types described above.
Conservative treatment of tailor’s bunion includes changing the type of footwear (wider shoes and avoiding high heels), orthopedic insoles, metatarsal pads, silicone orthoses and cleaning of the callus may produce a temporary improvement of symptoms. Also, anti-inflammatory drugs always prescribed by your doctor can reduce the inflammation and pain caused by this deformity.
Surgical treatment is the definitive long-term solution and aims to reduce the width of the foot and eliminate the lateral bony protrusion (tailor’s bunion).
To decide on the best operation, a careful preoperative physical assessment with radiographs and biomechanical study of the foot must first be performed.
For type I tailor’s bunion, the best surgical treatment is resection of the lateral bony protrusion of the foot. This procedure is the most commonly used because it is simple and has excellent results. Minimally invasive or percutaneous foot surgery allows this procedure to be performed on an outpatient basis through an incision of a few millimeters, without screws or pins, with immediate ambulation and a short postoperative period with little discomfort.
For type II tailor’s bunion, the most effective treatment is the removal of the bony protrusion accompanied by an osteotomy (“
“The purpose of the fifth metatarsal is to narrow the foot. These osteotomies may require fixation but with minimally invasive or percutaneous foot surgery it is not necessary because it allows an osteotomy to be performed without the need for a needle or surgical screw.
For type III and IV tailor’s bunion, a combination of the techniques mentioned above can be used, always after an exhaustive study of the foot by a medical specialist or podiatrist in foot surgery.
Treatment of tailor’s bunion at the Clínica San Román
At the San Roman Medical-Podiatric Clinic we perform a complete study of the foot to offer the most effective and personalized solution for this foot deformity. the most effective and personalized solution for this foot deformity.
If you would like more information about tailor’s bunion or any other foot pathology, you can contact Clínica San Román, where our team specialized in foot surgery will perform a comprehensive foot assessment.
Clínica San Román has 40 years of experience in minimally invasive or percutaneous foot surgery. The Clinic is registered and regulated by the Health Department to perform all types of medical, podiatric and minor foot surgery treatments.
Article published 28-10-2019
Prepared by Clínica San Román
Date of revision: 14-02-2020
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- FALLAT, L.M., 1990. Pathology of the fifth ray, including the tailor’s bunion deformity.
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- STEINKE, M.S. & BOLL, K.L., 1989a. Hohmann-Thomasen metatarsal osteotomy for tailor’s bunion (bunionette).
The Journal of Bone and Joint Surgery.American Volume.
- STEINKE, M.S. & BOLL, K.L., 1989b. Hohmann-Thomasen metatarsal osteotomy for tailor’s bunion (bunionette).
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- VIENNE, P., OESSELMANN, M., ESPINOSA, N., ASCHWANDEN, R. & ZINGG, P., 2006. Modified Coughlin procedure for surgical treatment of symptomatic tailor’s bunion: a prospective followup study of 33 consecutive operations.. Foot & Ankle International. 27(8), pp.573-580.