Tailor’s bunion, also called a bunionette, is an enlargement of the fifth metatarsal bone at the base of the little toe. Metatarsals are the long bones in your foot that connect your ankle to your toes. Tailor’s bunions are not as common as bunions of the head of the first metatarsal bone, but they are similar in symptoms and etiology.
A tailor’s bunion can be due to an inherent defect in biomechanical structure of the foot. The fifth metatarsal bone projects outward, while the little toe projects inward. This transferal results in the growth of a bony enlargement that becomes irritated whenever compressed by shoes. In other cases, a tailor’s bunion may not be derived from a biomechanical deformity, but rather a naturally occurring outgrowth of bone on the side of the fifth metatarsal.
A major cause of tailor’s bunion can also be due to inappropriate and often tight-fitting shoe gear. Most shoes available to customers are not adequately wide for the average foot, especially in the toe box. This can result in painful irritation of the soft tissue underneath your skin at the prominence of the fifth metatarsal bone.
If prevention fails, there are conservative treatments your podiatrist can provide which include:
- Avoid wearing tight-fitting footwear. Choose shoes that have a wide toe box and little or no heel elevation. Getting a proper fit is crucial.
- Fit in a toe spacing product. Called a toe spacer, it restores proper alignment of your fifth toe to the fifth metatarsal, and away from the fourth toe. Be sure to only wear this in shoes with a wide toe box.
- Bunionette pads may help reduce the pain.
- Anti-inflammatories, taken as directed, can help alleviate the pain and swelling.
- Corticosteroid injections may also help reduce the inflammation.
If conservative treatments fail to rid the pain associated with your tailor’s bunion, surgical treatment could be your next option. If the irritation is due to soft tissue enlargements such as a bursa, neuroma or ganglion, your podiatrist can easily remove it in a simple surgery. If the cause is due to a bony prominence of the fifth metatarsal, your podiatrist can surgically remove or shave off the offending portion of the bone.
Post-operative instructions vary depending on the individual, but in most instances the patient is allowed to walk in a surgical shoe following surgery.
By Barry Mullen