- Discussion:
- bunionette deformity may be created by wide 4-5 intermetatarsal angle;
- symptomatic plantar callus is 2nd to concomitant plantar flexion of the fifth metatarsal;
- soft corn caused by the pressure of the bone of the proximal phalanx of 5th toe (may be exacerbated by tight shoes);
- soft tissue surgery will not solve the problem and the offending agent is usually the condyle of the proximal phalanx of 5th toe;
-
associated 5th toe cross over deformity:
- 5th toe lies contracted in a dorsal medial direction over the 4th toe;
- Radiographs:
- Treatment: Diaphyseal Osteotomy:
- best method for correction is w/ long oblique osteotomy, which allows for medial displacement (and dorsiflexion if it is required);
Medial displacement metatarsal osteotomy for treatment of painful bunionette.
Treatment of bunionette deformity with longitudinal diaphyseal osteotomy with distal soft tissue repair.
MJ Coughlin.
Foot Ankle Int. Vol 11. 1991. p 195-203.
Hohmann-Thomasen metatarsal osteotomy for tailor's bunion (bunionette).
Metarsal head resection for bunionette: Long term follow up. HB Kitaoka and AD Holiday.
Foot Ankle Int.
Vol 11. 1991. p 345-349.
Modified Coughlin procedure for surgical treatment of symptomatic tailor's bunion: a prospective followup study of 33 consecutive operations.
