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The Journal of Bone and Joint Surgery (American) 83:1076-1082 (2001)
© 2001 The Journal of Bone and Joint Surgery, Inc.

Current Concepts Review

Bunionette

Manjunath Koti, MS(AIIMS), DNB(Orth), FRCS(Glas) and Nicola Maffulli, MD, MS, PhD, FRCS(Orth)

Manjunath Koti, MS(AIIMS), DNB(Orth), FRCS(Glas)
Department of Orthopaedic Surgery, University of Aberdeen Medical School, Polwarth Building, Foresterhill, Aberdeen AB25 2ZD, Scotland

Nicola Maffulli, MD, MS, PhD, FRCS(Orth)
Department of Trauma and Orthopaedic Surgery, Keele University School of Medicine, Thurnburrow Drive, Hartshill, Stoke on Trent, Staffordshire ST4 7QB, England. E-mail address: n.maffulli{at}keele.ac.uk

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

The bunionette, or tailor’s bunion, is a painful osseous prominence on the lateral aspect of the head of the fifth metatarsal. This prominence occurs in many individuals but seldom causes symptoms.

Orthotic devices may be useful if a symptomatic bunionette results from excessive pronation of the subtalar joint.

Operative management to decrease the width of the foot and the osseous prominence is indicated when nonoperative treatment can no longer control symptoms and when the patient has special demands, particularly in sports.

A proximal osteotomy is able to correct most deformities. A distal osteotomy is recommended if medial translation of the head for one-third of the width of the metatarsal shaft produces a normal fourth-fifth intermetatarsal angle.


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