Tailor's bunion is a condition caused as a result of inflammation of the
fifth metatarsal bone
The fifth metatarsal bone is a long bone in the foot, and is palpable along the distal outer edges of the feet. It is the second smallest of the five metatarsal bones. The fifth metatarsal is analogous to the fifth metacarpal bone in the hand.
As ...
at the base of the little toe.
It is usually characterized by inflammation, pain and redness of the little toe.
Often a tailor's bunion is caused by a faulty mechanical structure of the foot. The fifth metatarsal bone starts to protrude outward, while the little toe moves inward. This change in alignment creates an enlargement on the outside of the foot.
It is mostly similar to a
bunion
A bunion, also known as hallux valgus, is a deformity of the joint connecting the big toe to the foot. The big toe often bends towards the other toes and the joint becomes red and painful. The onset of bunions is typically gradual. Complicatio ...
(the same type of ailment affecting the big toe). It is called Tailor's bunion because in past centuries, tailors sat cross-legged, and this was thought to cause this protrusion on the outside aspect of the foot.
Patients will present with a history of pain of the lateral bunion, plantar callous, and pain that increases with constrictive shoe wear. Studies have shown that tight shoe wear can cause both bunions as well as Tailor's bunions.
Treatment
Non-surgical therapies include:
[
*Shoe modifications: wearing shoes that have a wide ]toe box
The toe box is the section of footwear that surrounds the toes on closed-toe shoes. Toe boxes that are too tight can cause injuries and foot deformities, whereas wider toe boxes may be used to treat or prevent common foot conditions such as Mor ...
, and avoiding those with pointed toes or high heels.
*Oral nonsteroidal anti-inflammatory drug
Non-steroidal anti-inflammatory drugs (NSAID) are members of a therapeutic drug class which reduces pain, decreases inflammation, decreases fever, and prevents blood clots. Side effects depend on the specific drug, its dose and duration of ...
s may help in relieving the pain and inflammation.
*Injections of corticosteroid
Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex of vertebrates, as well as the synthetic analogues of these hormones. Two main classes of corticosteroids, glucocorticoids and mineralocorticoids, are involv ...
are commonly used to treat the inflammation.
*Bunionette pads placed over the affected area may help reduce pain.
*An ice pack may be applied to reduce pain and inflammation.
Surgery is often considered when pain continues for a long period with no improvement in these non-surgical therapies.
Surgical therapies include:
* Distal and proximal osteotomies of the 5th metatarsal can be used to correct the intermetatarsal and metatarsophalangeal
The metatarsophalangeal joints (MTP joints), also informally known as toe knuckles, are the joints between the metatarsal bones of the foot and the proximal bones (proximal phalanges) of the toes. They are condyloid joints, meaning that an ellipt ...
angle causing the TB.
Diagnosis
Tailor's bunion is easily diagnosed because the protrusion is visually apparent. X-rays may be ordered to help the surgeon find out the severity of the deformity.
Types of Tailor's bunions
Type 1: The head of the 5th metatarsal is thickened and enlarged.
Type 2: A 5th metatarsal with an increased lateral curve and a normal fourth and fifth inter-metatarsal angle.
Type 3: Has the greatest lateral angular disposition of the 5th metatarsal compared to the 4th metatarsal, this phenomenon increases the 4th and 5th inter-metatarsal angles. This is generally the most symptomatic type of Tailor's bunion.
Type 4: A combination of at least two types of bunionettes (TB).
Lesser toe deformities leading to falls
Five studies examined associations between falls and foot disorders. Significant associations were found between falls and plantar fasciitis
Plantar fasciitis or plantar heel pain (PHP) is a disorder of the plantar fascia, which is the connective tissue which supports the arch of the foot. It results in pain in the heel and bottom of the foot that is usually most severe with the f ...
, corns or bunions
A bunion, also known as hallux valgus, is a deformity of the metatarsophalangeal joint, joint connecting the big toe to the foot. The big toe often bends towards the other toes and the joint becomes red and painful. The onset of bunions is typ ...
and lesser toe deformity (such as Tailor's bunions). The results of these studies show that "Older people who fell were more likely to have foot pain, hallux valgus
A bunion, also known as hallux valgus, is a deformity of the joint connecting the big toe to the foot. The big toe often bends towards the other toes and the joint becomes red and painful. The onset of bunions is typically gradual. Complicat ...
, and lesser toe deformity".
See also
* Tailor's muscle
The sartorius muscle () is the longest muscle in the human body. It is a long, thin, superficial muscle that runs down the length of the thigh in the anterior compartment.
Structure
The sartorius muscle originates from the anterior superior ili ...
* Bunion
A bunion, also known as hallux valgus, is a deformity of the joint connecting the big toe to the foot. The big toe often bends towards the other toes and the joint becomes red and painful. The onset of bunions is typically gradual. Complicatio ...
, also known as hallux valgus, a similar condition of the big toe.
References
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Foot diseases
Musculoskeletal disorders
Toes