Tailor's bunion | |
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Other names | Bunionette or Digitus quintus varus |
Radiograph showing a tailor's bunion | |
Specialty | Podiatry |
Tailor's bunion, also known as digitus quintus varus or bunionette, is a condition caused as a result of inflammation of the fifth metatarsal bone at the base of the little toe. [1]
It is usually characterized by inflammation, pain and redness of the little toe.
Often a tailor's bunion is caused by a faulty mechanical structure of the foot. The fifth metatarsal bone starts to protrude outward, while the little toe moves inward. This change in alignment creates an enlargement on the outside of the foot.
It is mostly similar to a bunion (the same type of ailment affecting the big toe). It is called Tailor's bunion because in past centuries, tailors sat cross-legged, and this was thought to cause this protrusion on the outside aspect of the foot.
Patients will present with a history of pain of the lateral bunion, plantar callous, and pain that increases with constrictive shoe wear. Studies have shown that tight shoe wear can cause both bunions as well as Tailor's bunions. [2]
Non-surgical therapies include: [1]
Surgery may be considered when pain continues for a long period and the non-surgical therapies do not yield improvement.
Surgical therapies include:
Tailor's bunion is easily diagnosed because the protrusion is visually apparent. X-rays may be ordered to help the surgeon find out the severity of the deformity.
Type 1: The head of the 5th metatarsal is thickened and enlarged.
Type 2: A 5th metatarsal with an increased lateral curve and a normal fourth and fifth inter-metatarsal angle.
Type 3: Has the greatest lateral angular disposition of the 5th metatarsal compared to the 4th metatarsal, this phenomenon increases the 4th and 5th inter-metatarsal angles. This is generally the most symptomatic type of Tailor's bunion.
Type 4: A combination of at least two types of bunionettes (TB). [2]
Five studies examined associations between falls and foot disorders. Significant associations were found between falls and plantar fasciitis, corns or bunions and lesser toe deformity (such as Tailor's bunions). The results of these studies show that "Older people who fell were more likely to have foot pain, hallux valgus, and lesser toe deformity". [3]
The foot is an anatomical structure found in many vertebrates. It is the terminal portion of a limb which bears weight and allows locomotion. In many animals with feet, the foot is a separate organ at the terminal part of the leg made up of one or more segments or bones, generally including claws and/or nails.
Toes are the digits of the foot of a tetrapod. Animal species such as cats that walk on their toes are described as being digitigrade. Humans, and other animals that walk on the soles of their feet, are described as being plantigrade; unguligrade animals are those that walk on hooves at the tips of their toes.
A bunion, also known as hallux valgus, is a deformity of the MTP joint connecting the big toe to the foot. The big toe often bends towards the other toes and the joint becomes red and painful. The onset of bunions is typically gradual. Complications may include bursitis or arthritis.
Pes cavus, also known as high arch, is a human foot type in which the sole of the foot is distinctly hollow when bearing weight. That is, there is a fixed plantar flexion of the foot. A high arch is the opposite of a flat foot and is somewhat less common.
A hammer toe, hammertoe or contracted toe is a deformity of the muscles and ligaments of the proximal interphalangeal joint of the second, third, fourth, or fifth toe, bending it into a shape resembling a hammer. In the early stage, a flexible hammertoe is movable at the joints; a rigid hammertoe joint cannot be moved and usually requires surgery.
A valgus deformity is a condition in which the bone segment distal to a joint is angled outward, that is, angled laterally, away from the body's midline. The opposite deformation, where the twist or angulation is directed medially, toward the center of the body, is called varus.
The flexor hallucis longus muscle (FHL) attaches to the plantar surface of phalanx of the great toe and is responsible for flexing that toe. The FHL is one of the three deep muscles of the posterior compartment of the leg, the others being the flexor digitorum longus and the tibialis posterior. The tibialis posterior is the most powerful of these deep muscles. All three muscles are innervated by the tibial nerve which comprises half of the sciatic nerve.
Morton's neuroma is a benign neuroma of an intermetatarsal plantar nerve, most commonly of the second and third intermetatarsal spaces, which results in the entrapment of the affected nerve. The main symptoms are pain and/or numbness, sometimes relieved by ceasing to wear footwear with tight toe boxes and high heels. The condition is named after Thomas George Morton, though it was first correctly described by a chiropodist named Durlacher.
Morton's toe is the condition of having a first metatarsal bone that is shorter than the second metatarsal. It is a type of brachymetatarsia. This condition is the result of a premature closing of the first metatarsal's growth plate, resulting in a short big toe, giving the second toe the appearance of being long compared to the first toe.
Hallux rigidus or stiff big toe is degenerative arthritis and stiffness due to bone spurs that affects the metatarsophalangeal joints (MTP) at the base of the hallux.
An accessory navicular bone is an accessory bone of the foot that occasionally develops abnormally in front of the ankle towards the inside of the foot. This bone may be present in approximately 2-21% of the general population and is usually asymptomatic. When it is symptomatic, surgery may be necessary.
Hallux varus is a clinical condition characterized by medial deviation of the great toe at the metatarsophalangeal joint. This condition, when acquired by adults, is usually caused by sports injury, surgical overcorrection of hallux valgus, or underlying causes such as arthritides.
Foot and ankle surgery is a sub-specialty of orthopedics and podiatry that deals with the treatment, diagnosis and prevention of disorders of the foot and ankle. Orthopaedic surgeons are medically qualified, having been through four years of college, followed by 4 years of medical school or osteopathic medical school to obtain an M.D. or D.O. followed by specialist training as a resident in orthopaedics, and only then do they sub-specialise in foot and ankle surgery. Training for a podiatric foot and ankle surgeon consists of four years of college, four years of podiatric medical school (D.P.M.), 3–4 years of a surgical residency and an optional 1 year fellowship.
March fracture is the fracture of the distal third of one of the metatarsals occurring because of recurrent stress. It is more common in soldiers, but also occurs in hikers, organists, and people whose duties entail much standing. March fractures most commonly occur in the second and third metatarsal bones of the foot. It is a common cause of foot pain, especially when people suddenly increase their activities.
Pigeon toe, also known as in-toeing, is a condition which causes the toes to point inward when walking. It is most common in infants and children under two years of age and, when not the result of simple muscle weakness, normally arises from underlying conditions, such as a twisted shin bone or an excessive anteversion resulting in the twisting of the thigh bone when the front part of a person's foot is turned in.
Syndesmosis procedure is one of the more than twenty bunion surgeries currently being performed. While the majority of bunion surgeries involve the breaking and shifting of bones, syndesmosis procedure is one of few surgical techniques that use a soft-tissue or non-osteotomy (non-bone-breaking) approach to afford the same correction. More than 130 different surgical techniques have been described for correction of one single condition of the foot: the bunion deformity.
Orthopedic surgery is the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopedic surgeons use both surgical and nonsurgical means to treat musculoskeletal injuries, sports injuries, degenerative diseases, infections, bone tumours, and congenital limb deformities. Trauma surgery and traumatology is a sub-specialty dealing with the operative management of fractures, major trauma and the multiply-injured patient.
Philip Radovic, D.P.M. is a professor and podiatric surgeon practicing in South Orange County, California.
Treace Medical Concepts, Inc. is a medical device company, headquartered in Ponte Vedra Beach, Florida, specializing in the design, manufacture, and marketing of foot and ankle surgical devices and biologics. Lapiplasty, Treace’s novel primary surgical product, advanced the treatment of bunions, surgically correcting the metatarsal bone, for the first time, in all three dimensions.
Akin osteotomy is a surgical procedure often used in the treatment of hallux valgus deformity, more commonly known as a bunion. A bunion is a bony bump that forms on the joint at the base of the big toe, often resulting in the toe pointing abnormally toward the second toe. Akin osteotomy is usually performed in conjunction with other procedures to correct the alignment of the toe and relieve associated symptoms. This procedure was first described by Akin in 1925.