Diagnosis and Treatment of Forefoot Disorders. Section 4. Tailor's Bunion

Abstract

Tailor’s bunion (also called bunionette) involves deformity of the fifth metatarsophalangeal joint (MPJ), much like a bunion that occurs medially. Although tailor’s bunion typically involves deformity with lateral prominence of the fifth metatarsal head, both lateral and plantar clinical pathology will be discussed in this document. Numerous factors can contribute to the development of a tailor’s bunion. Structural causes include a prominent lateral condyle, a plantarflexed fifth metatarsal, a splay foot deformity, lateral bowing of the fifth metatarsal, or a combination of these deformities (1-5). In addition, there may be hypertrophy of the soft tissues over the lateral aspect of the metatarsal head (6). Other contributing factors may include a varus fifth toe, hallux valgus with abnormal pronation of the fifth metatarsal, hindfoot varus, and flatfoot (7). Tailor’s bunion is seen most commonly in adolescents and adults. It has been reported that the mean age of presentation of tailor’s bunion is 28 years (range, 16–57 years) (8), with a female-to-male ratio greater than 2:1 (1). Significant History (Pathway 5, Node 1)