Bunionette and Bunion Deformity

Background:

It may be wrong but easy to blame the obvious. Bunionette is a perfect case in point. Most bunionettes are not at fault for its own pain but the bunion.



What is the bunionette (baby/tailor’s bunion)?

Bunionette is the bony prominence at the base of small toe from the opposite side of the bunion of big toe. The prominence is actually part of the normal anatomy of 5th metatarsal head. While bunion deformity is almost always abnormal, bunionette is mostly normal to the contrary of popular belief.



How would bunion contribute to bunionette pain?

Firstly, bunionette can only be painful in close-toe shoes that are either too narrow for a normal width forefoot or when the forefoot is too wide for regular shoes. Bunion increases the width of forefoot and thus tightness of regular shoes. Thus both bunion and bunionette would rub more against their side of close-toe shoes fighting for room. Therefore, bunionette is another victim of the bunion condition.

Another reason is the outer-side of a bunion foot has to bear abnormally more weight in walking due to function loss on the big toe side of a bunion foot.



Why would poor big toe function contribute to bunionette pain?

The big toe side of foot normally provides most (up to 80%) power for all foot activities. Bunion deformity impairs its function and inadvertently depends more on outer side of foot for walking. This would thus increase the pressure on bunionette against shoes and thus pain.



Should then bunion surgery also resolve bunionette pain?

Yes, an effective bunion surgery will not only narrow the forefoot significantly but also restore function of the big toe side of foot and thus spare bunionette of abnormal crowding and pressure and thus pain



Why do some bunionette pain persist after bunion surgery?

Some bunion surgeries may be able to straighten out the big toe to look better but not really narrow the forefoot to solve the crowding problem in regular shoes.

Even if a bunion surgery can narrow the forefoot but fails to restore big toe function may not help relieve pressure on the bunionette enough in walking for complete pain relieving.



Has syndesmosis procedure been able to help resolve bunionette pain and why?

The non-bone-breaking bunion surgery by syndesmosis procedure has been demonstrated by the Biomedical Engineering Department of Hong Kong Polytechnic University to be able to not only narrow the forefoot effectively but also restore the big toe function. After more than 1,600 syndesmosis procedures there has not been any need for surgery to relief bunionette pain yet in our experience.










Reference information: http://www.bunioncenter.com/bunion/bunionette.html
It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your Orthopedist for diagnosis and treatment.