Bunionette
Tailor's Bunion

General Considerations

• Painful prominence at 5^th metatarsal head laterally
• Originally described in tailors who sat cross-legged resulting in chronic pain and swelling over lateral aspect of 5^th metatarsal head
• Much more common in females
• Related to narrow footwear
• Less common than hallux valgus (bunion)
• May also be due to congenital structural abnormalities, anomalous ligament insertion, inflammatory arthropathies, previous foot surgery

Clinical Findings

• Chronic pain
• Redness of little toe
• Ill-fitting shoes
• Callous formation

Imaging Findings

• Enlarged and inflamed bursa over metatarsal head
• Increased angulation between the 4^th and 5^th metatarsals
  • Normal angle between 4^th and 5^th MTs is <8°; in bunionettes, it is >10°
• Enlargement of the head (dumbbell-shaped)
• Lateral bowing of the 5^th metatarsal shaft
• Medial deviation of phalanges of 5^th toe

Treatment

• Shaving callous
• Wider shoes or sandals
• Padding
• Surgery if symptoms not relieved by conservative means

Complications

• Complications of surgery can include malunion, nonunion, nerve injury, persistent pain and stiffness, infection

Bunionette. Frontal and oblique views of the foot demonstrate prominence of the
5th metatarsal head (white arrows) and increased angulation between the 4th and 5th metatarsals. There is also slight lateral bowing of the shaft of the 5th metatarsal (yellow arrows).
For these same photos without the arrows, click here
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Bunionette. eMedicine. Brown, C; Cullen, N.

Preoperative Assessment of Symptomatic Bunionette Deformity; Radiologic Findings. Karasick, D. AJR 1995; 164:147-14