A Review of Tailor's Bunion

Pathology
The pathology of the tailor's bunion is complex and controversial. However, the reviewed literature suggests that mild to debilitating pain associated with prominence of the fifth metatarsal head is due to either shearing or weightbearing forces. This prominence is thought to be the result of structural or biomechanical abnormalities, or a combination of both.

Whilst a bunion deformity of the first ray may take precedence in size and physical disfigurement; it may be no more painful or inconvenient than a fifth ray bunion for the patient. The ratio of literature between bunions and bunionettes would suggest that a tailor's bunion is of little significance in comparison to a hallux valgus deformity. However, a bunionette may prove extremely significant to the patient who endures chronic pain or difficulty with shoe fitting.

The bunionette is subject to various methods of treatment, including: padding, reduction, shoe modification, drug therapies, and surgery. Conservative measures to control the deformity should initially be employed; however invasive procedures may prove the only option in some cases. The hallux valgus deformity has spawned approximately one hundred differing surgical procedures in its history of treatment. The tailors bunion, seemingly only recognised over the last fifty years, has also given rise to various techniques in operative correction. Some of these have been developed specifically for the bunionette, but many have been modified from existing first ray bunion surgery. This report will provide an overview of the pathology, aetiology, clinical features, and conservative treatment related to the tailor's bunion deformity. A discussion of the more common procedures employed in bunionette correction will then be presented, along with radiography, classification, and possible complications related to the procedures.

Department of podiatry encyclopedia at Curtin University of Technology. By Matthew Benson

A Review of Tailor's Bunion