The tailor’s bunion is a symptomatic prominence of the fifth metatarsal bone on the outside portion of the foot. It is characterized by progressive angulation of the fifth metatarsal head and deviation of the small toe toward the other toes. Pain and occasional swelling with redness to the fifth metatarsal head at the fifth metatarsal phalangeal joint is often times seen.
The cause of the tailor’s bunion can be related to faulty biomechanics and the progressive change of the fifth metatarsal with an increase angulation of the bone that occurs slowly overtime. The tailor’s bunion is the counter part and less common to the “bunion” or hallux abducto valgus deformity. The name “tailor’s bunion” originated from tailors sitting in a cross legged fashion and excessive pressure occurring on the outside of the foot at the fifth metatarsal head.
Conservative treatment of the tailor’s bunion is supportive in nature and is focused on reducing inflammation with the temporary use of ice therapy and antiinflammtory medications like ibuprofen as well as the reduction of pressure in the region with the use of pads to take pressure off of the metatarsal head as well as wider toe box shoes. The most important single treatment is wearing shoes that provide additional room on the toebox. Lace or buckle closure shoes tend to afford a greater amount of toebox room. Casual or athletic shoes best fit the description of shoes that provide adequate room. Dress style shoes including heels, flats and loafers tend to increase pressure in the area.
Surgical correction of the tailor’s bunion may be required based on pain and failure of conservative therapy. The surgical relief of pain is generally achieved by creating a bone cut or osteotomy of the metatarsal bone and repositioning it to normal anatomic position.
The surgical reposition of the fifth metatarsal to it’s anatomic position will create more normal pressure from shoe gear in the region and will relieve pain.