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Tailors Bunion

What is a Tailor’s Bunion?

Derived from the Latin word “bunio,” meaning enlargement, a Tailor’s bunion affects the little toe or fifth toe joint. Similar to a bunion of the big toe joint, the fifth metatarsal splays outwards as the little toe curves inwards creating what appears to be a bump on the outside of the foot. The name originated from when tailors sat cross-legged on the floor and experienced irritation of this part of their foot. Another name for tailor’s bunion is also bunionette.

Who Gets Tailor’s Bunions?

Women are more frequently symptomatic with tailor’s bunions because of their choice of shoegear and tendency to have looser ligaments.  Wearing high heels is especially stressful on the joints of the foot as all of the body's weight rests there.  The foot is then abnormally forced into the narrow, pointed front of the shoe.  Although this compounds the problem, it does not create it. Inherited foot mechanics are largely responsible. People with flat feet or low arches are more prone to develop the problem than those with higher arches.

What Are the Symptoms?

Pain, swelling, and sometimes redness overlying the side of the little toe joint.

Pain is from pressure on the prominent area and is worsened by wearing dress shoes, causing the skin and deeper tissues around the tailor’s bunion to be swollen or inflamed. Calluses may form on the bottom of the foot as pressure begins to develop in that area.

What Are the Treatment Options?

Treatments vary depending on the severity of pain and deformity.

The main goal of early treatment is to relieve pressure on the tailor’s bunion. Padding is an important first step, as is wearing shoes that are large enough to comfortably accommodate the tailor’s bunion (such as sandals, athletic shoes or shoes made from soft leather).  Shoe repair shops can spot- stretch shoes for greater comfort giving the tailor’s bunion more room.  Narrow, confining, or high-heeled shoes should be avoided. To ease pain and inflammation around the joint, medications, such as nonsteroidal anti-inflammatory drugs or cortisone injections, may be prescribed.

What About Surgery?

When conservative treatment does not provide satisfactory relief from symptoms, or when the condition interferes with daily activities, surgery may be necessary.  Pain and deformity are significantly reduced in the great majority of patients who undergo tailor’s bunion surgery.  Surgery usually consists of making a bone cut in the fifth metatarsal and sliding it over to realign the joint and reduce the prominence. Screws are placed across the bone to hold it stable when it heals. The surgery may require use of a cast and limited weight-bearing until the bone has healed properly, usually around 6 weeks.

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