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Foot & Ankle

Understanding Bunionettes

: Causes and Treatments Introduction A bunionette is also commonly termed a tailor’s bunion and is typically defined as a lateral prominence of the fifth metatarsal head.

G
Greg Rubin
Sports Medicine Physician · February 5, 2023 · 3 min read

Overview

: Causes and Treatments A bunionette is also commonly termed a tailor’s bunion and is typically defined as a lateral prominence of the fifth metatarsal head. There are multiple theories as to the etiology of a bunionette. One risk factor for developing a bunionette is pes planus, as it leads to a hindfoot valgus and a compensatory rotation of the fifth metatarsal head laterally.

Symptoms

Other risk factors for developing a bunionette are a plantarflexed fifth metatarsal shaft, lateral bending of the fifth metatarsal shaft, and a prominent metatarsal head. There are other anatomical risk factors for developing a symptomatic bunionette, including a prominent lateral fifth metatarsal head and a “dumbbell” shape fifth metatarsal. Bunionette deformities are seen more commonly in females.

Causes and Risk Factors

Diagnosis Patients typically complain about lateral sided foot pain with constrictive shoeware. Examination should start with the patient standing to evaluate for pes planus or a hindfoot valgus. A concomitant hindfoot valgus with a bunionette is referred to as a “splay foot”.

Treatment Options

Clinical examination typically reveals a callus overlying the fifth metatarsal head on either the lateral, dorsolateral, or plantar surface (5,8). There may also be lateral eminence swelling. Hyperkeratotic lesions can also be seen due to continuous pressure over the lateral portion of the metatarsal.

Recovery

Lateral eminence swelling Standard radiographs should be obtained with lateral, AP, and oblique views taken (7,8). Typical angles measured are the metatarsophalangeal angle 5 (MTPA) and the 4-5 intermetatarsal angle (4-5 IM angle). Demonstration of the metatarso-phalangeal-5 angle and 4-5 intermetatarsal angle Classification is determined based on the radiographs.

When to See a Doctor

If you are experiencing symptoms that may be related to a bunionettes, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.

*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*

Foot & Ankle
G
Greg Rubin
Sports Medicine Physician
Sports Medicine Review contributor

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