Tailors Bunion

A Tailors Bunion is defined as a Bunion on the outside of the foot. A regular Bunion affects the big toe joint. The metatarsal bone migrates towards the inside of the body and the big toe migrates towards the second toe. With a Tailors Bunion the opposite is true. The fifth metatarsal migrates to the outside of the foot and the little toe migrates towards the fourth.

The deformity got its name due to the prevalence in Tailors. When Tailors would measure and fit clothing they would often cross their feet and put weight on the outsides of them. This would put additional weight on the fifth toes causing them to migrate towards the fourth toes.

Patients will normally present to our podiatry office when the Tailors Bunion becomes painful. Often the pain is due to rubbing in the shoes. In these cases the outside of the foot may appear red and a callus may begin to form. Tailors Bunions can also cause arthritis. Like regular Bunions when the metatarsal and digit are off of alignment the cartilage is not congruent. Meaning the cartilage is not lined up perfectly. This causes cartilage to rub on bone, which then causes breakdown of the cartilage. This often happens only in severe cases.

Often a Tailors Bunion is accompanied by a hammertoe of the fifth digit. In some cases the fifth digit can curl underneath the fourth digit causing pain during walking and callous formation.

Treatment of a Tailors Bunion consists of surgical and conservative options. Initially conservative treatment will be attempted. Conservative treatment consisting of padding or bracing and changes in shoe gear should be attempted.

The majority of cases that require surgery only require removal of the bump on the outside of the metatarsal head. This bump is an overgrowth of bone often due to rubbing of the shoes. In these cases removal of the bump will cure the pain caused by the Tailors Bunion.

In more severe cases the metatarsal bone has to be cut and moved to the inside. This is done to realign the cartilage and decrease the bump on the outside in very severe cases. The majority of cases if a hammertoe is also present on the fifth digit it can be repaired at the same time. The postop course depends on whether the metatarsal has to be cut and realigned or if only the bump is removed. If only the bump is removed the patient must wear a special boot for two weeks. If the bone is realigned the patient must wear the boot for 4 to 6 weeks.

If you are developing pain or deformity on the outside of the foot it is recommended that you be evaluated by one of our doctors. There are ways of decreasing the rate of progression of the deformity to avoid surgery.