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Posts for tag: bump on foot

June 15, 2015
Category: Uncategorized

     A TAILOR'S BUNION is a bump on the outside of the foot (just behind the little toe).  It is an enlargement (either a truly enlarged bone or a relative enlargment) of the head of the fifth metatarsal bone.  There are five metatarsal bones, one behind each toe.  The heads, or ends of these bones make up the "ball" of the foot.  A bunion is an enlargrment of the first metatarsal head, often accompanied by a turning or shifting of the big toe towards the smaller toes.  A TAILOR'S BUNION Is basically the reverse.  The fifth metatarsal head is enlarged, and the little toe often moves in toward the other toes.

     Tailor's Bunion deformity is also sometimes called a "bunionette" and may be an actual enlargement of the bone (where the head is larger on the outside) or a "relative enlargmenet."  This means the fifth metatarsal may not actually be bigger, it may just look bigger because the entire fifth metatarsal is deviated OR there may be a bend or splaying of the fifth metatarsal.  In other words, the bone may be normal at the base, near the center of the foot, but there may be a bend in the bone causing it to bow outwardly.  The name "Tailor's Bunion" is one case where the deformity is NOT named after a doctor, as many deformities or surgical procedures are named.  Instead, it is called a TAILOR'S Bunion, because years ago, people who tailored clothing sat barefoot in a crossed leg position.  This put pressure on the side of the little toe, causing it to push in, and causing back pressure on the fifth metatatarsal pushing it out.  

    Treatment for a tailor's bunion is usually surgical.  While no treatment may be needed if there is no pain, ulceration, or other associated deformity, in many cases there is pain over the "bump."  In mild cases, an ostectomy or removal of just the "bump" can be performed.  This is in those rare cases where the bone is actually enlarged and there is little or no deviation or bend in the bone.  In most cases, an osteotomy is needed.  Defined sometimes as a "surgical fracture", an osteotomy is when a cut is made in the bone, the head (containing the "bunion") is moved in (closer to the fourth metatarsal) and held in place with a pin, screw, or other form of fixation.  In very severe cases, where the entire fifth metatarsal is out of position, it may be necessary to make the bone cut at the base of the bone.  In older individuals, patients with diabetes and ulcerations that may not be candidate for an osteotomy, the entire fifth metatarsal head can be removed.  This is not advisable for young, healthy individuals, as the cosmetic result is often not as good, and it is possible to regrow the bone. 

      Conservative treatments for this condition are not often effective long-term, but can include padding, wider shoes, injections of steroid solutions into the soft tissue (bursa) which may be inflamed and painful, the use of oral anti-inflammatory medications, and orthotic devices (especially if pain is plantar or on the bottom of the foot rather than just the side).  

      Tailor's bunion deformity is a common condition.  The condition may or may not be painful, and treatment is usually dependent on the severity of the deformity and symptoms.



Richard S. Eby, DPM
EbyFootCare and Laser Center

7348 East Brainerd Road'

Chattanooga, TN.  37421