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Bunionette / Tailor's Bunion

By Deborah Fields, BSc (Hons), PgDip, MCIPR

A bunionette, also known as a tailor’s bunion, is a bony deformity at the base of the fifth metatarsal in the little toe. It bears some similarities to a bunion, a bone deformity that develops at the base of the big toe.

The deformity can be painful for the patient, especially if it becomes inflamed. The bunionette protrudes from the foot making it difficult for the patient to wear their usual size of shoe. The deformity widens the size of the foot and causes the little toe to point in towards the fourth toe. The patient is likely to need to alter the width of the shoes they wear as a result of the condition.

The alternative name for the deformity, tailor’s bunion results from tailors who used to sit in a cross-legged position on hard floors with their little toes rubbing against the ground. The friction between the foot and the ground is believed to have given them bunionette problems, with the fifth toe pointing inwards.

Who gets Bunionettes?

The tailor’s bunion is not as common as the bunion despite it having similar causes and symptoms. The condition is thought to be experienced primarily by women in western nations more than others. This is believed to be due to the types of footwear used in different countries. In western nations, people tend to wear narrow-fitting shoes that can aggravate the condition due to the shoes rubbing against the bone and pushing the fifth toe inwards.

As with the bunion, bunionettes also appears to run in families so there may be a genetic factor that predisposes some people to the deformity more than others. The metatarsal in the fifth toe may be prone to protrusion.  It may be that a person with a tailor’s bunion is more likely to have certain biomechanical traits that impact the structure of bones in the feet. As the condition develops, the ligaments in the fifth toe stretch to bring the toe closer to the fourth toe.

Some patients can experience it as their feet tend to spread out when they touch the ground. Others may experience the problem as an unexpected result of a foot surgery such as unsuccessful adjacent metatarsal surgery or hind foot surgery. In addition, arthropathies - inflammation of the joints - can encourage the condition.

Complications of Tailor’s Bunion

Patients can develop a corn, a potentially painful thickening of the skin, between the fourth and fifth toes as a result of rubbing between the toes and the protrusion caused by the tailor’s bunion. Arthritis, an inflammation of the joints, may also develop in the fifth toe.

The patient’s way of walking may change as well because of the pain that the bunionette causes. They might also need to alter their shoes.

How is Tailor’s Bunion Diagnosed?

Affected individuals need to see a podiatrist to assess the extent of their deformity. He or she may need to take an X-ray of the affected foot to find out what kind of action should be taken. This will help the medical professional determine how best to treat it. In some cases, the patient may be advised to undergo surgery of the foot.

Reviewed by Susha Cheriyedath, MSc

References

Last Updated: May 31, 2016

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