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A bunionette, also called quintus varus or Tailor’s Bunion, is a common deformity of the foot. It consists of a deformation of the 5th metatarsal, which takes on a curved appearance, and results in painful excessive pressure on the outer edge of the foot. A bony protrusion is seen at the base of the 5th toe. This is actually the contact between the edge of the metatarsal head and the skin. The discomfort is mainly due to pressure against the shoe.
Normal foot
The metatarsals are straight
Bunionette
The arched shape of the 5th metatarsal results in a conflict with the shoe
The pain is due exclusively to the conflict between the metatarsal head and base of the phalanx in relation to the shoe. It increases when wearing narrow or high-heel shoes.
When the discomfort caused by this pressure means that it is difficult to wear shoes or results in frequent pain, it is advisable to consult a doctor.
When conservative treatment is inadequate, surgery should be offered.
The principle of surgical treatment is to restore a normal shape to the metatarsal, i.e. to straighten it. Conventional techniques consist of open surgery during which the metatarsal is cut, moved, and fixed in the correct position by a screw.
We believe that the percutaneous option is by far the best solution. These recent techniques allow a realignment of the metatarsal using a 1-mm incision without the need for fixing screws. A bone wedge is removed using specific instruments. The most lateral part of the metatarsal is left intact and acts as a door hinge, meaning that the cut can be closed and the bone axis realigned (closing wedge osteotomy). No material is implanted; a dressing holds everything together during the healing process. If necessary, one section of the metatarsal head can be excised through the same incision.
