Miscellaneous Injuries to the Foot and Ankle (Bunionette Deformity)

The tailor’s bunion or bunionette deformity is characterized by a painful prominence of the lateral aspect of the fifth metatarsal head which leads to chronic irritation of the overlying serous bursae. It is more frequent in women (3/1) than men and is associated with diverse intrinsic and extrinsic causative factors. Common symptoms include pain and/or hyperkeratosis on the external aspect of the fifth metatarsal head, plantar pain and/or plantar hyperkeratosis, an increase in local temperature and reactive bursitis. Initially, conservative treatment should be indicated, with the intention to alleviate the symptoms by using wide shoes, interdigital orthosis, and pain medication. Only 10–23% of the patients require surgery. When conservative treatment fails after 6 months, surgical treatment is advocated. Surgical techniques can be open or minimally invasive. The method preferred by the author is the distal oblique percutaneous metaphyseal osteotomy. The general complication rate after surgical correction of the bunionette deformity is low, with the most frequent complications being delayed healing, mal-union, pseudoarthrosis, transfer metatarsalgia and deformity relapse.