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Health Inset > Human Anatomy > Tailor’s Bunion (Bunionette)

Tailor’s Bunion (Bunionette)

Tailor’s Bunion Definition

Tailor’s Bunion, also known as Bunionette, is a painful condition of the foot similar to Bunion (painful swelling of the bursa in the big toe). The fifth metatarsal bone located near the base of the little toe sometimes becomes inflamed, leading to this abnormality.

The condition is called the Tailor’s Bunion because tailors used to suffer from the disorder very frequently. They had to sit cross-legged and barefoot for long periods of time and the outside edge of the feet rubbed on the ground, applying extra pressure on the area that resulted in Bunionette. The disease can also be referred to as Metatarsalgia and Intractable Plantar Keratosis.

Tailor’s Bunion Causes

An inherited fault in the foot’s mechanical structure can result in this kind of foot injury. The existing fault can cause changes in the bony framework of the foot which leads to an enlargement in certain areas. As a result, the metatarsal bone in the fifth toe begins to protrude outward and the toe starts to move inward. This change leads to the development of a bump on the side of the foot if the area is irritated by wearing a tight shoe.

In some cases, Bunionette is actually a bone outgrowth or bony spur which develops on the fifth metatarsal bone. Wearing narrow shoes can put excessive pressure on the sides of the foot which ultimately causes this condition.

Bone destruction caused by some specific types of Arthritis, such as the Psoriatic and Rheumatoid Arthritis, can lead to misalignment of joints which results in the formation of a bunion. Sometimes, the normal functioning and pull of the foot muscles and tendons may be affected by some neuromuscular diseases, causing deformation and imbalance of the structure of the foot. Other causes of foot structure damage include:

  • Muscle trauma
  • Bone or muscle surgery
  • Irregularity in the length of the two legs

Certain activities, such as ballet dancing and running while wearing tight shoes can also increase the risk of development of this disorder.

Tailor’s Bunion Symptoms

This condition generally aggravates if an individual continues to wear tight shoes and put pressure on the affected area. The symptoms get worse with the advancement of the injury, leading to other serious bone and muscle disorders.

Following are some of the principal symptoms of Bunionette:

  • Development of a bump near the base of the little toe
  • Numbness and a throbbing pain in and around the swollen area
  • Gradual increase of the painful sensations over time
  • Redness and irritation in the area of the foot where the skin rubs against the shoe
  • Development of a callus in the affected skin area
  • Swelling of the bursa located in the fifth toe, leading to a painful condition name Bursitis
  • Severe rubbing and pressure, which can even result in an ulcer on the affected area
  • Grinding sensation with movement in the base of the little toe

Tailor’s Bunion Diagnosis

The evident protrusion at the side of the little toe helps to make the basic diagnosis. This is followed by studying of the symptoms of patients to rule out the possibility of a fracture or some other bone injury. An x-ray can be done to find out the exact causes and extent of the abnormality. X-ray can also help the doctor to decide whether the deformity requires surgery. Sometimes, a doctor may also order an MRI for confirming the diagnosis.

Tailor’s Bunion Treatment

Most cases of the condition can be treated with appropriate medications, physical therapy and exercise. It is also important to take some measures for avoiding any further injury to the affected area. This includes:

Non-surgical Treatment

Following are the different non-surgical treatments used to cure this condition:

Shoe Modification

It is advisable to wear shoes with a broad toe box. One should also avoid wearing shoes with high heels and pointed toes.

Padding

Protecting the swollen area with Bunionette pads also helps to reduce the pain.

Oral Medications

NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen can help to relieve the inflammation and pain.

Ice Pack

Applying an ice pack on the affected area helps to reduce the pain. It is advisable to wrap the ice in a piece of cloth to avoid applying it directly to the skin and preventing “Ice burns”.

Injection Therapy

Corticosteroid injections are sometimes used for treating the inflamed tissues around the injured joint.

Taping

A physician may tape the affected feet for pain-relief. Taping restricts the movement of the injured toe and protects it from further damage.

Orthotic Devices

Comparatively severe cases of the disorder are treated with custom orthotic devices. These devices include day and night splints, braces, toe spacers, toe straightener and gel Bunion guards.

Tailor’s Bunion Exercises

Knee and hip flexion along with extension exercises help to keep the pain in control. Wiggling the toes is a useful exercise that can help to prevent the condition from occurring. Doing some foot stretching exercises is beneficial for restoring the movement of the toes. These exercises also help the toes to regain their proper positions.

Surgical Treatment

Operation may be required in cases where all the above-mentioned treatment measures fail to reduce the pain and keep the swelling in control. Removal of the Bunionette is one of the most commonly used corrective surgeries. Majority of these surgeries are performed under an ankle block anesthesia. Various factors, like the extent of the deformity as well as the patient’s age and activity level are considered by a surgeon while deciding the appropriate operative procedure.

Bunionette Removal

In this surgery, a small incision is made by a surgeon over the bump for repairing the abnormality. The surgeon then removes the protrusion with a chisel and smoothens the bone edges. The incision is closed with stitches after the surgery is complete. The stitches are removed 10-14 days after the surgery is performed.

Home Remedy

It is possible to keep the swelling and pain associated with this disorder in control by following certain remedial guidelines at home. These include:

  • Wearing wide and flat shoes to avoid putting pressure on the fifth metatarsal bone.
  • Wearing proper socks can keep the toes protected by providing a cushion effect
  • Using pain reliever sprays and gels
  • Applying ice packs on the affected area for 10 minutes everyday
  • Using stretchable shoes to prevent the swelling from getting worse

Tailor’s Bunion Prognosis

The prognosis of the disorder is generally positive with timely and proper treatment. The patient has to wear special post-operation shoes to keep the foot from any damage following the surgery. He or she may also require crutches for a short time after the operation. In some very rare instances, Bunionette can lead to blood clots in the foot which can turn life-threatening. In most cases, however, the patients achieve full recovery. The recovery time required by the patients generally depends on the treatment option used.

Tailor’s Bunion Prevention

It is not possible to prevent the congenital defect in the foot structure, which is the most common cause of this disorder. People with an abnormal foot structure should wear proper shoes and avoid high heels to prevent the Bunion from developing. Wearing shoes with spacious toe boxes prevents putting extra pressure on the sides of the foot. Bunion guards, a padding or cushion over the bony areas at the toe base, can be used for protecting the foot. Applying some ice and using some anti-inflammatory medications can help to prevent the development of Bunionette in cases where the skin becomes swollen and irritated due to pressure or some injury.

Tailor’s Bunion Pictures

The following pictures show how this disorder affects the external appearance of the foot.

Picture of Tailor's Bunion

Picture 1 – Tailor’s Bunion

 Image of Tailor's Bunion

Picture 2 – Tailor’s Bunion Image

Proper treatment is required for curing the pain and correcting Tailor’s Bunion. After treatment, the patients are allowed to go back to their normal activity level.

References:

http://www.foothealthfacts.org/footankleinfo/tailors-bunion.htm

http://orthopedics.about.com/od/toeproblems/a/bunionette.htm

http://www.orthogate.org/patient-education/foot/bunionette-tailors-bunion.html

https://nwfootankle.com/foot-health/drill/3-Problems/35-Tailor%27s%20Bunion

http://www.ctfootgroup.com/tailors-bunion-bunionette.html

By   Last updated August 22nd, 2013

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