Bunionette (Tailor’s Bunion)
Overview
A bunionette, or tailor’s bunion, is a prominence on the outer side of the forefoot at the base of the little toe. The bump may be visible without causing pain. Wider footwear, padding and pressure redistribution are first-line treatments. Surgery is considered for persistent pain and shoe conflict—not for appearance alone—and the procedure must correct the underlying fifth-metatarsal alignment rather than simply shaving the bump.
Symptoms
- Pain, redness or swelling over the outer fifth metatarsal head.
- Rubbing in narrow or stiff shoes.
- A callus over or beneath the prominence.
- Little-toe deviation, crossover or stiffness.
- Pain beneath the outer forefoot from altered load.
Assessment
Assessment reviews footwear, the location of callus and pain, flexibility of the little toe, the whole forefoot and the presence of a high-arched foot, flatfoot or inflammatory disease. A painful bursa, corn, wart, stress injury or nerve problem can mimic symptoms.
Weight-bearing X-rays show the fifth-metatarsal shape and angle, toe alignment and other forefoot deformity. Surgery is not planned from the size of the bump alone.
Non-surgical treatment
- Shoes with a wider toe box and softer outer material.
- Padding, a silicone sleeve or modification of a pressure point in the shoe.
- Callus care and an insole or orthosis when load beneath the fifth metatarsal contributes.
- Activity modification during an inflamed flare.
- Pain-relieving or anti-inflammatory medicine after checking that it is suitable for your health and current medicines.
When may surgery be considered?
Surgery may be discussed when persistent pain, recurrent inflammation, callus or shoe conflict remains limiting despite appropriate footwear and pressure-relief measures. It is not recommended for the appearance of a painless bump.
Simple shaving may be sufficient only for a selected small prominence with acceptable alignment. When the fifth metatarsal is malaligned, shaving alone is often inadequate and has a higher risk of recurrence. A controlled bone cut (osteotomy) of the fifth metatarsal is then used to correct position and is fixed with one or more screws. Severe or recurrent deformity may require correction further along the bone.
Recovery
A postoperative shoe or Moonboot is used, and weight-bearing instructions depend on the bone cut and fixation. Elevation is important during the early period. The little toe and outer forefoot can remain swollen for several months.
Normal shoes are resumed when the wound, bone healing and swelling permit. Wide footwear may still be more comfortable after correction.
Risks and limitations
- Infection, wound problems, numbness or painful scar.
- Delayed or failed bone healing, healing in the wrong position, or irritation from the fixation.
- Recurrence, under-correction or over-correction.
- Stiffness or altered position of the little toe.
- Transfer pain elsewhere in the forefoot.
- Blood clots, anaesthetic complications or need for further surgery.
Frequently asked questions
Is a bunionette the same as a bunion?
It is a similar prominence but occurs at the fifth metatarsal and little toe rather than the big-toe side.
Can shoes cause it?
Foot shape is important. Narrow shoes can aggravate pressure and symptoms but are not the sole cause in every person.
Can the bump be shaved off?
Only in selected cases. When the fifth metatarsal is malaligned, a controlled bone cut is usually needed to reduce the risk of recurrence.
Will I need crutches?
This depends on the procedure, fixation and weight-bearing plan. Some people can bear protected weight in a postoperative shoe, while others need greater restriction.
Can it recur?
Yes. Recurrence is possible because of anatomy, healing, alignment and ongoing footwear pressure.
General information
This page provides general information only. It cannot diagnose your condition or replace advice from a clinician who has assessed you. Your treatment and recovery plan may differ from the examples described here. Follow the instructions from your treating team. In an emergency, call 000 or attend the nearest emergency department.