Tailor's bunion deformity is very similar to the bunion deformity (hallux valgus) of the big toe joint but it affects the little toe joint.
It is less common than a big toe bunion, but can still be very painful.
In effect the 5th metatarsal (long bone to the little toe) protrudes, making the foot wider (splaying) and the little toe joint becomes inflamed when being rubbed in footwear. It can be managed by wearing sensible wider footwear to prevent the rubbing.
Surgery to a Tailor's bunion is more straight-forward than big toe bunion surgery. An incision is made to the outside of the foot over the bunion and 5th metatarsal. The 5th metatarsal (the long bone to the fifth toe) is cut and realigned into its correct position. This reduces the splaying and the foot appears narrower. If there is a lump on the joint this will be shaved off also.
In our practice we use a scarf or z-osteotomy (type of bone cut), which is fixed with two small bone screws. The surgery takes around 20 minutes (per foot) and can be undertaken under either a local or general anaesthetic, normally as a day case procedure. You will be required to weight-bear on the heel with crutches for the first week. After this our patients wear a walker-boot for 3 further weeks before transferring to a roomy shoe such as trainer or Ugg boot etc. We will see you for follow-ups to ensure you have an easy recovery and have wound care and scar-care advice. Normally we review at one week, two weeks and six weeks. We may do a final review at 3-months. Some patients require physiotherapy although most can mobilize the joint themselves. All patients will require an x-ray of the foot or feet, prior to surgery and at least one afterwards. All surgery carries the potential for risks and complication and this will be discussed verbally and then written information on the surgery and risk will be sent to you.
Overall recovery will take many months as swelling always takes a long time to reduce in the foot, however, we allow swimming from four weeks, light gym work such as cross-trainer, cycling and rowing, from six weeks and running from 10 weeks. We normally advise at least two weeks off from work, although this may be longer if you are on your feet al lot at work. We also allow driving after 4-weeks. We advise against long-haul flight (over 5 hours) for at least 4 weeks after surgery to reduce the risk of deep vein thrombosis (DVT).
For further information:
There are 3 basic classifications used for Tailor's bunion deformity:
Type I Tailor's bunion: - enlarged 5th metatarsal head.
Type II Tailor's bunion – bowing (outwards) of the 5th metatarsal.
Type III Tailor's bunion: - increased angle between the 4th and 5th metatarsal (splaying).
Picture below to show before and after x-ray of Tailor's bunion correction (type III)