Bunionette Deformities
Introduction
This is Patient Education Article – Bunionettes. It explains the basics of the pathology including signs, symptoms and basic treatment options.
What is a Bunionette?
A bunionette, also known as a baby bunion or a tailor’s bunion, is described as a bump on the side of the little toe. The deformity received its name centuries ago, when tailors sat cross-legged all day with the outside edge of their feet rubbing on the ground. This constant rubbing led to a painful bump at the base of the little toe.
With a Bunionette, the small toe leans toward the other toes, rather than pointing straight ahead. This creates a prominence on the side of the small toe. The side of the small toe will often become painful, inflamed and swollen from shoe wear or rubbing.
Bunionettes can be a progressive disorder and may become more painful as they worsen. As the small toe leans toward the other toes, the tendons and ligaments can become imbalanced or contacted and the bump can become increasingly prominent.
What Causes a Bunionette?
A bunionette is usually caused from malalignment of the bones of the small toe. When malalignment occurs there is an imbalance of the tendons and ligaments around the toe joint which worsens the deformity. Bunionettes are not necessarily caused by tight fitting shoes but it can be made worse in this manner.
Bunionettes are characterized by the shape and curvature of the long bone in the foot, the metatarsal. There may be an abnormally large prominence of the metatarsal head, a curved metatarsal shaft or both. Depending on the cause of the bunionette helps determine the best treatment.
Symptoms
Symptoms occur most often when wearing tight fitting shoes or those that crowd the toes, such as high heels or those with a small toe box. Symptoms may also occur if shoes do not fit appropriately and the foot slides around in the shoe. These symptoms include
- Pain or soreness
- Inflammation and redness
- Burning sensation
Other conditions which may appear with bunionettes include calluses, ingrown toenails and sores between the toes.
Diagnosis
Bunionettes are readily apparent–you can see the prominence at the small toe or side of the foot. However, to fully evaluate your condition, Dr. DeMill will take x-rays to determine the degree of the deformity and assess the changes that have occurred.
Because bunionettes are progressive, they don’t go away, and will usually get worse over time. But not all cases are alike–some bunionettes progress more rapidly than others. Once Dr. DeMill has evaluated your specific case, a treatment plan can be developed that is suited to your needs.
Treatment
Sometimes observation of the bunionette is all that’s needed. A periodic office evaluation and x-ray examination can determine if your deformity is advancing.
Early treatments are aimed at easing the pain of bunionettes, but they won’t reverse the deformity itself.
These options include:
- Changes in shoe wear. Wearing the right kind of shoes is very important. Choose shoes that have a wide toe box and forgo those with pointed toes or high heels, which may aggravate the condition.
- Padding.Pads placed over the area of the bunionette can help minimize pain. You can get bunionette pads or bunionette guards from a medical supply store or even some shoe stores.
- Activity modifications. Avoid activity that causes bunionette pain, including standing for long periods of time.
- Medications.Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may help to relieve pain. These medications are available in oral or topical form.
- Icing.Applying an ice pack several times a day helps reduce inflammation and pain.
- Orthotic devices. In some cases, custom orthotics or supportive inserts may be of benefit.
When is Surgery Needed?
When the pain of a bunionette interferes with daily activities, it’s time to discuss surgical options. There are a few different types of bunions and therefore different types of surgery to fix them as well. You and Dr. DeMill will discuss the option and together you can decide if surgery is best for you.
Recent advances in surgical techniques have led to a very high success rate in treating bunionettes.
A variety of surgical procedures are performed to treat bunionettes. The procedures are designed to remove the “bump” of bone, correct the changes in the bony structure of the foot, as well as correct soft tissue changes that may also have occurred. The goal of these corrections is the elimination of pain. In selecting the procedure or combination of procedures for your specific case, Dr. DeMill will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.
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