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Bunionette pain or classic tailor’s bunion is an enlarged or prominent “bump on the outside of the foot” near the fifth toe. Most tailor’s bunions are inherited and form as the joint responds to abnormal pressure on the foot from tight, restrictive or flat shoes without support. Pain ranges from dull to sharp depending upon the level of irritation and compression of the nerves that are around this area.
The bunionette is a prominent edge of bone – more specifically the fifth metatarsal head. And since the pressure or callus that is formed from the pressure creates foot pain by pressing on the nerves in this area, treatment on the conservative level starts with larger or better shoes with softer material on the outside. Although you don’t need to see the podiatrist for this information, there are other non surgical treatments besides padding (Dr Scholls silicon, mole skin, etc.) like callus debridement and cortisone injections.
As for a permanent ‘fix’ – surgery is quite simple and the majority of these deformities can be a simple removal of the prominent or sharp edge of bone. This can be performed by a trained foot surgeon at an out patient surgical facility using a very light anesthesia. The more serious deformities are usually inherited and can involve an osteotomy or bone cut to move the head of the fifth metatarsal into a more normal anatomical position. The post operative period for the simple procedure involves partial to full weight bearing and back into shoes after sutures are removed 2-3 weeks. The osteotomy will take up to 6-8 weeks to be healed and like most surgical fractures, non weight bearing for 4-6 weeks.
Make sure that the shoe has enough room at the end about the width of your thumb and that the toe box (front of the shoe) is high enough to allow your toes to move freely.
Anti-inflammatory medication can help with the chronic pain, but are not much help with the acute pain
There are an array of over the counter pads that can be placed to relieve the pain.
Temporary arch supports or custom molded orthotics can minimize the pressure on the foot position causing the pressure. These devices can be a viable solution without surgical intervention.
The bone structure causing the pressure is either remodeled and smoothed down or repositioned. Incisions are minimal and vary (average 1.5cm to 3/4 inch) and sutures are removed at 2 weeks. The procedure is performed at an outpatient facility under sedation. Partial weight bearing is allowed after 48 to 72 hours of non weight bearing if the bone is only remodeled.
Partial weight bearing is allowed after 1 to 3 weeks of non weight bearing with crutches if the bone is also repositioned.
CAUTION: This is an actual surgery performed on a patient – Contains Graphic Material
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