Tailor's bunion, also called a bunionette, is a prominence or boney enlargement of the fifth metatarsal bone at the base of the little toe. The metatarsals are the five long bones in each foot behind the toes. The tailor's bunion occurs at the outside of the foot on the fifth metatarsal "head," located at the far end of the bone where it meets the toe. Tailor's bunions are not as common as bunions, which occur on the inner side of the foot at the base of the big toe, but they are similar in symptoms and causes.
The deformity received its name centuries ago, when tailors sat cross-legged all day with the outside edge of their feet rubbing on the ground. This constant rubbing led to development of a painful bump at the base of the little toe.
Causes
Genetics or family inheritance play a role in developing the bunionette and in the functioning of the foot. Often there is faulty mechanical structure of the foot and biomechanics or functioning of the foot that leads to changes in the bones of the foot leading to the development of an enlargement (bump). The fifth metatarsal bone also starts to drift outward, while the little toe moves inward toward the other toes. This shift creates a bump on the outside of the foot that becomes irritated whenever a shoe presses on it. Sometimes a tailor's bunion can be only a bony spur (an outgrowth of bone) on the side of the fifth metatarsal head without the metatarsal drifting outward.
Regardless of the cause or type of Tailor's bunion, the symptoms are usually aggravated by wearing shoes that are too narrow in the toe, causing constant rubbing and pressure.
Symptoms
The symptoms of tailor's bunions include redness, swelling, and pain at the site of the enlargement. These symptoms occur when wearing shoes that rub against the enlargement, irritating the soft tissues underneath the skin and producing inflammation.
Diagnosis
Tailor's bunion is easily diagnosed. X-rays are ordered to help the podiatrist determine the cause and extent of the deformity.
Non-surgical treatment
Treatment for tailor's bunion begins with non-surgical therapies. Your podiatrist may recommend one or more of the following:
Shoe modifications: Choose roomy, comfortable shoes that have a wide toe box i.e. – round or square mouth shoes and avoid narrow shoes with pointed toes or high heels.
Padding: Bunionette pads placed over the area may help reduce pain.
Oral medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may help relieve the pain and inflammation.
Icing: An ice pack may be applied to reduce pain and inflammation. Wrap the ice pack in a thin towel rather than placing ice directly on your skin.
Injection therapy: Injections of corticosteroid may be used to treat the inflamed tissue around the joint.
Orthotic devices: In some cases, custom orthotics or shoe inserts may help.
Surgery
If you continue to have pain at your bunionette, cannot find or wear shoes because of the size of your bunionette, or if you continue to have problems after receiving non-surgical treatment, it may be time to consider surgery.
Bunionette surgery is an outpatient surgery. When selecting the procedure, the doctor will consider the extent of your deformity based on the x-ray findings, your age, your activity level, and other factors like your health status. The recovery time will vary, depending on the procedure or procedures performed.
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