A bunionette, also known as a tailor's bunion, is a bony prominence at the lateral 5th metatarsal head. It is the lateral counterpart of the more common bunion of the first metatarsophalangeal joint.
Bunionettes are visible on clinical examination as an erythematous swelling overlying the 5th metatarsal head. They may be tender on palpation.
They are thought to be caused by narrow/restrictive footwear. Some individuals may be predisposed to developing a bunionette due to an abnormal transverse metatarsal ligament, or an enlarged 5th metatarsal head.
Typically seen as a varus deformity at the 5th metatarsophalangeal joint. Increased angulation can also be present between the 4th and 5th metatarsals, e.g. a widening in the gap between the 4th and 5th metatarsal heads.
Treatment and prognosis
Conservative management is the first line of treatment, with use of wide-fitting footwear and orthotics. Surgical management involves osteotomy and resection.
History and etymology
In the pre-modern era, tailors used to suffer with this condition due to prolonged sitting in a cross-legged position, with subsequent pressure on the lateral aspect of the 5th metatarsal head against the floor.
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