Bunionette (Tailor's Bunion)

A bunionette — also called a tailor's bunion — is a structural deformity of the fifth metatarsophalangeal joint at the base of the little toe. It is the lateral equivalent of the more familiar hallux valgus bunion that occurs at the base of the big toe. Where a bunion produces a prominence on the inner edge of the foot, a bunionette produces a prominence on the outer edge.

The name 'tailor's bunion' derives from an era when tailors commonly sat cross-legged for long periods, placing the outer border of the foot against hard flooring. The chronic pressure and friction at the fifth metatarsal head produced the characteristic prominence that became associated with their trade.

A bunionette develops when the fifth toe drifts inward toward the fourth toe and the fifth metatarsal head shifts outward — a structural change that creates a painful bony prominence at the outer ball of the foot. The deformity is progressive, worsening over time without intervention. The rate of progression varies between individuals and is influenced by foot structure, footwear choices, and the underlying mechanics of the fifth ray.

The primary symptom is pain and irritation at the outer ball of the foot where the prominence contacts footwear. Narrow shoes, pointed toe boxes, and any footwear that compresses the outer foot are particularly aggravating. Overlying soft tissue thickening, bursitis, and callus formation are common as the prominence is chronically irritated by shoe contact.

Bunionettes frequently coexist with bunions — patients who have the foot structure and mechanics that predispose to a bunion at the first metatarsophalangeal joint often have the same structural tendency at the fifth. When both deformities are present, Dr. Gunter evaluates and addresses them together as part of a comprehensive forefoot plan.