Do you have swelling and a visible bump at the bottom of your little toe? It may be a Tailor’s Bunion.
What is a Tailor’s bunion?
A Tailor’s Bunion also known as a bunionette forms alongside your little toe. Tailor’s bunion results in the bony framework of the foot and a bump on the outside of the foot that is painful and irritated when your shoe presses against it. A Tailor’s bunion can also be a bony spur (an outgrowth of bone) n the side of the fifth metatarsal head.
The exact causes of Tailor’s bunion are not clear, but Tailor’s bunion can develop for several reasons:
Biomechanical abnormality: If there is excess motion in one part of the foot when stability is needed, changes in foot structure can occur. The gradual separation between the metatarsal bones that leads to a bunion is an example of this.
Hereditary: genetic factors play a role in predisposing some people to develop Tailor’s bunion.
Footwear: Poor shoes like high heels and pointed toe boxes, exacerbate the condition by speeding up the development of Tailor’s bunion, by making them more painful. This is at least one of the reasons Tailor’s bunions are much more common in women than men.
Conservative
These conservative treatments aim to reduce pressure over the painful area but do not correct the deformity.
Padding: Padding over the painful area may help relieve some of the pressure and reduce pain
Footwear modification: Obtaining proper shoes that will accommodate the width of the forefoot will reduce pressure from shoes and reduces pain.
Orthoses: Correcting abnormal biomechanics of the foot may help relieve pain
Non-steroidal anti-inflammatories: If the source of pain is bursitis, taking NSAIDs may help pain relief.
Surgical
Surgical treatment for Tailor’s bunions is usually recommended when conservative treatments have failed to correct the deformity.
There are many procedures designed to address Tailor’s bunion, and each has different indications. Typically, Tailor’s bunion surgery involves:
Cost & Item Codes – Our fees are quoted on a case-by-case basis after your initial consultation with the surgical podiatrist as each patient presents differently and each surgery varies from patient to patient. Please book an initial consultation to discuss this further.
Scans – We recommend you have weight bearing x-rays prior to your appointment.
Telehealth – We may be able to offer an initial telehealth appointment if you live a distance away. Phone one of our friendly staff to see if this is possible for you. We may ask you to email some photos prior to your appointment. (1. from patient looking down at the front of their foot/feet 2. if someone can take a photo at floor level from behind of foot/feet)
Do I need surgery? – Although your doctor may recommend an operation for your Tailor’s bunion to correct the deformity, it is your decision if you go ahead with the operation or not. Tailor’s bunions tend to progress, usually slowly with the bump becoming more prominent and uncomfortable.
Duration – The procedure typically takes between 30-45 minutes to complete, and patients can usually return home the same day.
Anaesthesia – Tailor’s Bunion surgery can be performed under general anaesthesia, local anaesthesia, or regional anaesthesia, depending on the doctor’s and the patient’s preferences.
Medications – Your doctor will discuss all medications with you on your initial consultation.
Smoking – If you are a smoker, you need to stop the habit of smoking 4 weeks before your operation for normal healing and reduce postoperative complications. Nicotine is known to stop bones from healing.
Patients must follow their doctor’s instructions carefully during recovery to ensure proper healing and minimize the risk of complications.
The recovery process following Tailor’s bunion surgery varies depending on the type of surgery performed and the individual patient. In general, the following timeline can be expected:
Immediately after surgery: Go home and rest. Elevate your foot as often and as much as possible to reduce swelling. Take pain medication as instructed and avoid smoking. Wear post-operative shoe all the time, even at bed for the first 2 weeks. Place a plastic bag over your foot when showering.
Some blood ooze can be expected in the bandage, but if worried, contact the number given.
The first few days: Patients will need to spend most of the time with the operated foot raised to reduce swelling as much as possible. You should restrict your walking in the postop shoe to minimal activities such as going to the bathroom only. Your wound needs to be kept dry until stitches are removed around 10-14 days.
1-2 weeks: Patients must wear a special postop shoe to protect the foot and allow for proper healing.
Minimal weight bearing with foot/feet elevated, getting up for essential things only like toilet breaks 5-10 minutes maximum per hour.
Do not pull at scabs but let them fall away naturally. If your wound becomes red, swollen or sore, you need to see your surgeon.
2-4 weeks: You may be weight bearing as tolerated in your post-op shoe. Movement is limited out of the house and patients are expected to rest and elevate as much as possible even when they are advised they are able to walk.
4-6 weeks: Your doctor will guide you on your transition into soft comfortable shoes.
Rest – 1-2 weeks (minimal weight bearing for essential things only like bathroom breaks 5-10 minutes maximum per hour)
Walk – 2-4 weeks (movement limited outside of house)
Driving – 4-8 weeks (for any hospital procedures under general anaesthesia, you cannot drive until after 24 hours when you are off narcotics. Therefore, you will need someone to drive you home from hospital)
Return to sedentary work – 2-4 weeks (If you work at a desk with minimal time on your feet and you are able to elevate your foot/feet)
Return to active work – 6-8 weeks (If you have a physical job or are standing a lot and unable to elevate your foot/feet)
Low impact exercise – 8 weeks (slow walking, cycling, golf using a caddie)
High impact exercise – 12 weeks (fast walking, running, jumping, playing sport)
The swelling often takes up to six months to go down completely. You should always wear comfortable shoes that have enough space for your toes. Wearing shoes with high heels or pointed toes may cause more toe problems in the future.
Some possible complications following Tailor’s bunion surgery include pain, infection, bleeding, scarring, joint stiffness, nerve damage, recurrence of deformity, delayed bone healing, under-correction. Patients should contact their doctor if they experience any signs of complications, such as fever, redness, or increased pain in the affected foot.
As with any surgical procedures, Tailor’s bunion surgery also carries complications.
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Do you have a bony, painful bump at the base of your big toe? Bunions can form at this joint and will not go away on their own. This doesn’t mean that your lifestyle has to be affected, we can help.
