TAILOR'S BUNION - DIGITUS QUINTUS VARUS
Pain on the outside of the little toe?
A tailor's bunion – known medically as digitus quintus varus, and also as a bunionette – is a deformity of the fifth metatarsal in which that bone shifts outwards (laterally). As a result the joint at the base of the little toe protrudes visibly outwards, while the little toe itself often rotates slightly inwards. A painful pressure point develops on the outer side of the foot, which typically causes symptoms under load or in tight shoes.
In appearance the deformity resembles a hallux valgus, but it affects the little toe rather than the big toe. The skin over the protruding head of the joint can become inflamed, and calluses, corns or chronic pressure pain develop – particularly where the foot is loaded abnormally or the footwear is unsuitable.
How pronounced it is varies considerably from person to person – from a barely visible deviation through to a markedly deformed outer edge of the foot.
How does a tailor's bunion develop?
A tailor's bunion develops when the fifth metatarsal deviates outwards. This shifts the little toe joint outwards, while the little toe itself often turns inwards.
- Tight or pointed shoes, which exert pressure from the side
- A splay foot with flattening of the transverse arch
- Genetic predisposition or a family history
- Sustained overloading, for instance through long periods of standing, sport or hard surfaces
- Changes in the connective tissue, above all with increasing age
Symptoms
The symptoms of a tailor's bunion often develop gradually and are noticed at first only as "pressure pain at the little toe". Over time, however, the situation can get worse – above all with sustained loading or unsuitable footwear. How marked the symptoms are depends on the extent of the deformity and on individual pain perception.
Pain
Local pain or a burning sensation on the outer side of the foot, particularly at the joint at the base of the little toe
Swelling
Irritation, redness or even swelling, particularly after longer periods of loading
Visible prominence
A visible prominence or redness on the outer edge of the foot
Treatment options for a tailor's bunion
Treatment of a tailor's bunion depends on the extent of the deformity, the pattern of symptoms and the individual demands placed on the foot. The aim is to reduce the pressure on the sensitive joint at the base of the little toe, to relieve inflammation and to restore the function of the foot. Both non-surgical measures and surgical procedures are available.
Treatment options
Non-surgical and surgical – we will find the right approach for you
Wearing wide, foot-friendly shoes
Wide, foot-friendly footwear reduces the pressure on the sensitive joint at the base of the little toe and can noticeably reduce irritation and pain.
Protective pads or silicone rings
Protective pads or silicone rings shield the sensitive prominence from friction inside the shoe and prevent painful pressure points or corns.
Insoles
Purpose-made insoles with support for a splay foot, or with soft cushioning, take load off the forefoot, correct the mechanics of the foot and can noticeably reduce the pain of a tailor's bunion.
Physiotherapy
Physiotherapy can help to correct muscular imbalances and strengthen the muscles of the foot, and so reduce the load on the little toe joint in the long term.
Medication
With acute irritation, anti-inflammatory drugs such as ibuprofen or diclofenac can relieve pain and reduce the local inflammation around the tailor's bunion.
Distal chevron osteotomy of the fifth metatarsal
With this technique the bone is cut in a wedge shape and fixed again in the corrected position – usually with a small screw. It is well suited to mild and moderate deformities.
Weil osteotomy
This method is used with more pronounced deformity, or where there is additional loading of the head of the metatarsal. It corrects the length and the axis of the bone and can also treat pain under the forefoot (metatarsalgia).
Soft-tissue balancing (lateral release or capsular tightening, for example)
In addition to correcting the bone, it may be necessary to release or tighten shortened parts of the joint capsule or tendons in order to bring the toe into its natural position.
Frequently asked questions about tailor's bunions
What exactly is a tailor's bunion?
Where does the name "tailor's bunion" come from?
Is a tailor's bunion the same as a hallux valgus?
When should I seek medical advice?
Does a tailor's bunion always need surgery?
Our foot specialists
Experienced consultants for tailor's bunions and foot surgery
