Tailor’s Bunion

What is a Tailor’s Bunion?
Tailor's BunionA tailor’s bunion or bunionette is a painful area of bone (5th metatarsal head) on the outside of the foot just behind the 5th toe.  The 5th metatarsal head is typically prominent on the outside of the foot and therefore causes the pain when wearing shoes or just walking.

How do you develop a tailor’s bunion?

The 5th metatarsal bone on the outside of your foot drifts further outward causing symptoms to occur.  This may happen for several reasons.  Tight fitting shoes is a very common cause and also easily corrected.  Structural problems caused by decreased arches can cause the 5th metatarsal bone to splay outwards resulting in pain.  The 5th metatarsal can also rotate out and become more prominent due to the abnormal pulling of muscles.  These are the most common causes and can be fixed easily via conservative or if need be surgical treatment.

What are the conservative options to correct a tailor’s bunion?

Changing shoe gear to a more loose fitting shoe will reduce symptoms because the 5th metatarsal bone will not rub up against the inside of the shoe.  This option is the most cost effective and is typically the first solution.  Padding to the area of the boney prominence may help if changing shoe gear is not an option, as padding will prevent the tailor’s bunion from hitting the inside of the shoe as well.  Custom orthotics are considered since the cause of the tailor’s bunion is related to the structure of the foot.  If the foot arch is maintained and the foot is supported properly then the symptoms will improve and the progression of the tailor’s bunion will slow down.  The custom orthotics will help to prevent having to undergo surgical correction for the tailor’s bunion in the future.

What are the surgical options to correct a tailor’s bunion?

There are several options when considering surgical intervention for tailor’s bunion correction and minimally invasive surgical techniques (MIS) may be utilized to correct the problem. MIS techniques involve shaving down and moving over the metatarsal head using a rotary burr.  This procedure is performed through very small openings in the skin.  Patient’s prefer this option since the procedure does not require a large opening in the skin.  The smaller opening results in decreased pain and swelling, and has a lower risk of complications.  The open surgical treatment requires a larger opening and has an increase in swelling and pain.  Both styles of surgery may involve cutting of the metatarsal bone and shifting the 5th metatarsal head towards the inside of the foot.  This surgery does not require any pin or screw fixation but this is up to the discretion of the surgeon.  Some bunionettes are very large and require screws to hold the correction in place.

How long is the recovery period after surgery?

The patient should be back to normal activities between four and six weeks after tailor’s bunion correction.  This allows time for the bones and skin to heal properly.  Custom orthotics are used after the bone is completely healed to help prevent the problem from coming back.  The sutures if there are any will come out between ten and fourteen days.  After the sutures are removed the patient is allowed to shower the foot.  If MIS techniques are used then no sutures will be required and the patient may bathe after the first follow up visit (3 days later).

How do I prevent a tailor’s bunion?

Custom orthotics is the primary way to prevent a tailor’s bunion.  If the proper alignment of the foot can be maintained when walking then the abnormal pull of the muscles will decrease and therefore help to prevent the deformity.  If the medial arch is supported then the arches will not collapse.  Preventing the arch from falling down prevents not only tailor’s bunions from occurring but also helps to prevent hammertoes, regular bunions, achilles tendinitis and several other foot problems.

Content written and provided by Advanced Podiatry