Treatment of Bunionette Deformity



In this article, surgeons from the Miller Foot and Ankle Institute in North Carolina review a condition called Bunionette Deformity. Most people are familiar with the term bunion. It refers to a bump alongside the joint at the base of the big toe.

A bunionette is a similar deformity alongside the base of the little toe. The cause of bunions in either toe is usually narrow shoes or some other kind of chronic pressure. Bunionette deformity is also called tailor’s bunion. It was named after clothing tailors who developed the problem from sitting on the floor with their legs crossed. These bunions formed from constant pressure along the outside edge of the foot.

Treatment is often nonsurgical. Wider shoes and padding are used first. Sometimes the shoes can be stretched or a larger shoe size is needed. Patients are advised to avoid shoes with a pointy toe. They should look for a shoe with a large, square-shaped box. The box is where your toes are placed inside the shoe.

About 10 to 20 per cent of the patients with bunionettes aren’t helped by these measures. Surgery may be needed to remove part of the bone and/or realign the joint. The authors describe in detail each individual operation that can be done. These include:

  • lateral condylar resection
  • metatarsal head resection
  • distal osteotomy
  • proximal osteotomy
  • diaphyseal osteotomy

    Surgery isn’t always the perfect answer. Problems can occur with deformity afterwards. Blood vessels can get damaged in the area. Bone infection and osteonecrosis (bone death) can occur. Most of the time, the surgery does help. Patients may have to be careful after the operation not to put any weight on the bone for a few weeks. They gradually increase to full-weight bearing and return to normal function.