Tailor’s Bunion

Dr. Vincent Giacalone

Dr. Vincent Giacalone

Podiatric Medicine & Surgery

466 Hook Rd., Suite 24D, Emerson, NJ 07630

Phone: 201-261-0500

Tailor’s Bunion

What is a Tailor’s Bunion?
Tailor’s bunion, also called a bunionette, is an enlargement of the fifth metatarsal bone at the base of the little toe. The metatarsals are the five long bones of the foot. The enlargement that characterizes a tailor’s bunion occurs at the metatarsal “head,” located at the far end of the bone where it meets the toe. Tailor’s bunions are not as common as “regular” bunions, which occur on the inside of the foot, but both are similar in symptoms and causes.

The symptoms of tailor’s bunions include redness, swelling, and pain at the site of the enlargement. These symptoms occur when wearing shoes that rub against the enlargement, irritating the soft tissues and nerves underneath the skin and producing inflammation and pain.

Why do we call it “tailor’s bunion”? The deformity received its name centuries ago, when tailors sat cross-legged all day with the outside edge of their feet rubbing on the ground. This constant rubbing led to a painful bump at the base of the little toe.

Causes of a Tailor’s Bunion
Often a tailor’s bunion is caused by an inherited faulty mechanical structure of the foot. In these cases, changes occur in the foot’s bony framework that result in the development of an enlargement. The fifth metatarsal bone starts to protrude outward, while the little toe moves inward. This shift creates a bump on the outside of the foot that becomes irritated whenever a shoe presses against it.

Sometimes a tailor’s bunion is actually a bony spur (an outgrowth of bone) on the side of the fifth metatarsal head. Heredity is the main reason that these spurs develop.

Regardless of the cause, the symptoms of a tailor’s bunion are usually aggravated by wearing shoes that are too narrow in the toe area, producing constant rubbing and pressure. In fact, wearing shoes with a tight toe box can make the deformity progressively worse.

Diagnosis
Tailor’s bunion is easily diagnosed because the protrusion is visually apparent. X-rays may be ordered to help determine the cause and extent of the deformity.

Treatment:
Non-surgical Options

Treatment for tailor’s bunion typically begins with non-surgical therapies. Dr. Giacalone may select one or more of the following options:

* Shoe modifications: Wearing the right kind of shoes is critical. Choose shoes that have a wide toe box, and avoid those with pointed toes or high heels.

* Oral medications: Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may help relieve the pain and inflammation.

* Injection therapy: Injections of corticosteroid are commonly used to treat the inflamed tissue around the joint.

* Padding: Bunionette pads placed over the area may help reduce pain. These pads are available from Dr. Giacalone or at a drug store.

* Icing: An ice pack may be applied to reduce pain and inflammation. Wrap the pack in a thin towel rather than placing ice directly on your skin.


When Is Surgery Needed?
Surgery is often considered when pain continues despite the above approaches. Surgery is highly successful in the treatment of tailor’s bunions.

In selecting the procedure or combination of procedures for your particular case, Dr. Giacalone will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.  The surgery is performed on an out-patient basis under local anesthesia with IV sedation.

Dr. Giacalone has been trained specifically and extensively in the diagnosis and surgical treatment of foot disorders.  Dr. Giacalone has been board certified by The American Board of Podiatric Surgery since 1995 and is a Fellow of the American College of Foot and Ankle Surgeons. Dr. Giacalone practiced for 10 years at the Diabetes Foot & Ankle Center at the Hospital for Joint Diseases in New York City.  Dr. Giacalone performs surgery at Hackensack University Medical Center (HUMC) in Hackensack, HUMC @ Pascack Valley in Westwood and Surgicare Surgical Center in Oradell.