A bunionette deformity is an abnormal bony prominence, or bump, on the outer side at the base of the fifth toe the pinky toe at the metatarsophalangeal joint (MTPJ). Podiatrist bony prominence can start out small and painless but become larger and more painful over time.
When bunionettes become larger, it usually is because of growth of the bony prominence, a curved shape to the fifth MTPJ, or splaying of the fifth metatarsal away from the fourth metatarsal. The condition is also known as a tailor’s bunion.
Treatment of Bunionette
The initial treatment of a bunionette is non-surgical. This can include wearing shoes that are roomier with a wide toe box to avoid rubbing on the bony prominence and padding the fifth toe using a toe sleeve. These treatment options are designed to reduce the discomfort over the prominent fifth toe or MTPJ.
Some simple modifications can help relieve the pain of a tailor’s bunion, although they won’t get rid of the bump. Try these remedies:
· Put a silicone bunion pad over the tailor’s bunion to relieve pain and prevent the bunion from rubbing against your shoe.
· Wear shoes that are flexible and have a wide toe box. Avoid wearing narrow, pointed shoes and high heels.
· Do calf stretches twice per day. Stand facing a wall with your toes pointing toward the wall. Step back with the affected leg to stretch the calf. Hold the position for 30 to 60 seconds.
Treatment of a bunionette should always focus on non-surgical options. These include:
· Changing footwear
· Wearing shoes with a wider toebox or sandals
· Padding the bunionette
When you look for the right footwear, make sure the ball of your foot fits well in the widest part of the shoe. This may mean you need to buy a larger size of shoe or a wide shoe.
When the bunionette is inflamed, you can apply a cold pack for 20 minutes at a time, several times per day. Be sure not to apply ice or a frozen pack directly to your skin.
A nonsteroidal anti-inflammatory medication (NSAID) such as Advil (ibuprofen) or Aleve (naproxen) can help reduce swelling and relieve pain.
Surgery of Bunionette
If your bunionette is painful even after wearing wide, comfortable shoes, if you cannot wear comfortable shoes because of the size of your bunionette, or if you continue to have problems around the bony prominence after non-surgical treatment, your foot and ankle orthopaedic surgeon may recommend surgery.
In the few patients who have persistent symptoms despite these treatments, surgical correction of a bunionette is an option. Surgery is performed to realign the bone so that it does not point outward.
Bunionette surgery is usually an outpatient surgery, meaning you can go home the same day as surgery. It involves removing the bony prominence of the bunionette. In a larger bunionette that is causing an alignment problem, breaking the fifth metatarsal and restoring normal alignment may be necessary.
The goals of Podiatrist are to remove the bony prominence and correct alignment to decrease pain. Surgery should be avoided if you have poor circulation or uncontrolled diabetes, if you are a chronic steroid user, or if you smoke cigarettes. These are risk factors for delayed healing of incision and bone.
Specific Techniques
The type of surgery to correct the bunionette depends on the shape of the fifth metatarsal bone, type of bunionette, and patient’s wishes.
If patients have a painful fifth toe prominence without a bony growth, the surgery usually involves a removal of the painful soft tissue of the fifth toe.
Patients with a Type 1 bunionette deformity have a bony prominence at the fifth metatarsal head at the outer part of the bone where the toe meets the foot. During surgery, this bony growth is removed.
If patients have a curved shape to their fifth toe (Type 2 bunionette) or angle (Type 3 bunionette) between the fourth and fifth metatarsal, then an osteotomy is often done. This osteotomy is done to straighten out the fifth metatarsal.
If a bunionette deformity is treated with an osteotomy, the bone may be held straight with a steel wire, screw, or plate and screws, depending on the surgeon’s preference.
Expectations for Recovery of Bunionette
After the surgery, patients may need to stay off their operated foot with no weight or heel weight bearing on it for a period of weeks. Patients will need to wear a post-surgical shoe or a short CAM boot on their foot to keep it protected after surgery.
You may also need to use crutches or a walker depending on your activity level and pain. In severe deformities, some surgeons will place a short leg splint to better protect the surgical correction.
The specific amount of time that a patient’s foot is protected after surgery depends on the type of surgery and the surgeon’s post-op protocol. The operated foot will need to be elevated above the level of the heart as much as possible for at least the first few days. This will help to decrease swelling.
You may have to wear a splint or boot for 3 to 12 weeks to protect your foot while it heals. You’ll have to stay home from work for a few weeks, especially if your job involves a lot of walking.
Nonsurgical treatments Podiatrist can often resolve bunion symptoms within 3 to 6 months. With surgery, full recovery can take up to three months. Swelling in the affected toe might take as long as a year to fully go down.
Doing foot and ankle exercises after surgery can help keep your joints flexible while you heal. You might also need physical therapy.
