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Bunionette on the little toe - Surgery

What is a bunionette?

A bunionette is a lump at the base of the little toe. In some cases it is accompanied by inflammation of the bursa at the site of the lump. A bursa is a small, fluid-filled cavity beneath the skin. The little toe can usually move normally with a bunionette and the sensation of blood circulation in the toe is also normal. With a bunionette the head of the outermost metatarsus, the bone in the foot behind the little toe, sticks out a little too far. As a result a lump forms on the outside of the foot. There are different reasons why the head of the metatarsus may protrude in this way.

A bunionette forms as a result of pressure on the side of the foot. The bunionette is also called a tailor’s bunion, because tailors often suffered from this condition in the past. When working, tailors sat cross-legged on the floor in the ‘tailor’s position’ and a bunionette formed due to the pressure on the side of the foot. Nowadays, in many cases the cause of a painful bunionette is often a combination of a hereditary disposition and wearing shoes that are too narrow. If your shoe constantly puts pressure on the same place, over time it becomes increasingly painful.

Complaints

The lump rubs against the side of the shoe and this is painful. Bursitis at the site of the lump can also cause excruciating pain. The pain is most severe when wearing shoes. If the lump is large it may be difficult to find any suitable shoes.

Diagnosis

The diagnosis can usually be made clinically. An X-ray is recommended to distinguish between the different forms.

Treatment options

There are both surgical and non-surgical options for tackling this.

Non-surgical:

With non-surgical treatment your shoe is adapted or you receive a device that helps you to walk more comfortably. Non-surgical treatment is the best choice if the bunionette does not yet cause a great deal of pain and you can still wear shoes without any problems. Non-surgical treatments are also possible for a severe bunionette. Read about the options below.

  • Shoe advice: low heels, wide shoes, supple leather
  • Stretch the shoe at the spot concerned
  • Therapy sole: especially combined with a splay foot
  • Therapy socks
  • Gel layer
  • Felt

In some cases an operation will be required to reduce the complaints. Surgery should only be considered if non-surgical treatment fails. A bunionette is surgically treated in different ways. The operation performed depends on the type and severity of the lump.

  • Removing the piece of bone
  • Moving the head of the metatarsus
  • Sawing through part of the metatarsus

In some cases this procedure can be performed percutaneously, which means the correction is made via a small stitch-size incision.

This content was written by : Dr. Stijn MuermansDr. Mark van DijkDr. Jan Van Oost

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