Tailor's bunion, also known as digitus quintus varus or bunionette, 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 metatarsophalangeal joint, MTP 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 ...

(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 deformity, foot deformities, whereas wider toe boxes may be used to treat or prevent common foot condition ...

, and avoiding those with pointed toes or high heels. *Oral

nonsteroidal anti-inflammatory drug Non-steroidal anti-inflammatory drugs (NSAID) are members of a Indication (medicine), therapeutic drug class which Analgesic, reduces pain, Anti-inflammatory, decreases inflammation, Antipyretic, decreases fever, and Antithrombotic, prevents bl ...

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 invo ...

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 may be considered when pain continues for a long period and the non-surgical therapies do not yield improvement. 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) are the joints between the metatarsal bones of the foot and the proximal bones (proximal phalanges) of the toes. They are analogous to the knuckles of the hand, and are consequently known as toe knuck ...

angle causing the tailor's bunion.

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 is a disorder of the plantar fascia, which is the connective tissue that supports the Arches of the foot, arch of the foot. It results in pain in the heel and Sole (foot), bottom of the foot that is usuall ...

, corns or bunions 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 MTP 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. Compli ...

, and lesser toe deformity".

References

{{reflist Foot diseases Musculoskeletal disorders Toes

Treatment

Diagnosis

Types of Tailor's bunions

Lesser toe deformities leading to falls

See also

References