A bunionette is similar to a bunion but on the outside edge or lateral side of the foot. It is sometimes referred to as a “tailor’s bunion” due to the fact that tailors once sat cross-legged all day with the outside of their feet rubbing on the ground. This produced a pressure area and callus at the base of the fifth toe.

Anatomy

A bunionette is most likely caused by an abnormal prominence over the fifth metatarsal head rubbing on shoes that are too narrow. Some folks have a widening of the foot as they grow older until the foot spreads or “splays.” This can cause a bunion on one side of the foot and a bunionette on the other of the patient continues to wear shoes that are too narrow. The constant pressure produces a callus and a thickening of the bursa over the prominence, leading to a painful knob on the outside of the foot.

Symptoms

The symptoms of a bunionette include pain and difficulty buying shoes that will accommodate the deformity. The swelling in the area causes a visible bump that some people find unsightly.

Diagnosis

The diagnosis of a bunionette is usually obvious on physical examination. X-rays may help to determine whether the joint has arthritis or if there is an abnormal growth from the metatarsal bone.

Treatment

Treatment is very similar to that of a bunion deformity. Anti-inflammatory medications can be helpful in the early stages. Shoes that have a wider toe box and a lower heel often resolve the problem after a few weeks. Small pads or the generous use of lamb’s wool to pad the deformity can decrease the irritation. If all else fails, your surgeon may recommend surgery.

Surgery

Surgery involves removing the prominence along the metatarsal bone and tightening the soft- tissue structures to straighten the 5th toe. Sometimes a cut needs to be made in the bone to reduce the deformity such as in a bunion or hallux valgus. Although initially very successful, if you return to tight shoes the deformity frequently returns.