Based in the heart of NY, Advance Foot and Ankle Solutions offers the best facility for performing bunionette surgery, while catering to all other various foot and ankle problems. Look no further when you can have direct access to the globally acclaimed specialist team of foot and ankle surgeons, supervising & managing your bunionette surgery with diligence and dedication.
Advance Foot and Ankle Solutions support team is absolutely attentive to your requirements related to bunionette surgery. Call & book an appointment right away for professionally diagnosed, treated and empathetically cured foot and ankle issues, to lead a wholesome, enviable lifestyle.
The Basic Anatomy & Pathophysiology Of A Bunionette
The Basic Anatomy
A bunionette deformity, also called a tailor’s bunion, is an abnormal bony lump or protuberance that forms along the outer (lateral) side of the 5th toe or metatarsophalangeal joint (MTPJ). It happens as small and painless when the fifth metatarsal bone enlarges or shifts outward. The fifth metatarsal is the very bottom bone on the little toe.
A bunionette is similar to a regular bunion but in a different location. Typical bunions grow on the inside of the foot below the big toe. Bunionettes grow on the outside of the foot at the base of the little toe.
The Basic Pathophysiology
A bunion can be painful, especially if it rubs against your shoe. This problem can become larger and more painful over time. When bunionettes become larger, it is usually because of growth of the protuberance, a curved shape to the fifth MTPJ, or both. Although bunionettes aren’t as common as regular bunions, they are a cause of chronic pain and shoe-fitting problems in individuals whose feet are characterized by a widened forefoot.
No single, universally acceptable procedure exists for all patients. In Western society, the occurrence of bunionettes is related to narrow, constricting footwear. Females represent up to 90% of symptomatic patients in some nations.
Classification Of The Bunionette Deformity
Bunionette deformities can be classified into three types on the basis of their appearance on plain films, as follows:
- Type 1 Lesion has an enlarged head as an isolated lesion
- Type 2 Lesion has an abnormal lateral bowing of the fifth metatarsal
- Type 3 Lesion has a 4-5˚ intermetatarsal angle (IMA) in excess of the normal 6-8°
Signs & Indications Of The Bunionette Deformity
- A Swollen Bump on the outside of your little toe (5th metatarsal)
- The Bump usually starting out small, but growing larger with time
- The Protuberance appearing as red and painful
- Bunionettes occurring in one or both the feet with varying degree
The Underlying Causes Of The Bunionette Deformity
Causes of bunionettes have been divided into 3 major categories:
- The Extrinsic Causes include the following:
- Trauma that can be either acute or chronic
- Poorly Fitting Footwear such as narrow, high-heeled shoes
- Loose Ligaments in your foot
- Tight Calf Muscles at your hind leg
- The Intrinsic Causes include the following:
- Congenital Lateral Bowing of the metatarsal shaft
- Abnormal Intermetatarsal Ligament Insertion with prominence of the fifth metatarsal
- Brachymetatarsia that most commonly affects the 4th metatarsal of young and adolescent females
- Primary Hypertrophy of the metatarsal head
- Congenital Splayfoot as a predisposing lesion
- The Iatrogenic Causes include the following:
- Failed Adjacent Metatarsal Surgery
- Residual Misalignments From Hind Foot Surgery
- Inflammatory Arthropathies
The Diagnostics Of The Bunionette Deformity
The diagnostic procedure of the bunionette deformity comprises of the following steps:
- Laboratory Studies that include the following:
- Standard Preoperative Hematology Tests
- Evaluation Of Arthropathy
- Investigation of Diabetes
- Obtaining Cultures For Infected Lesions
The Course Of Treatment
Both home-based conservative and clinical based treatment options are available at your disposal. Your orthopedic specialist is the best person to decide the most appropriate regimen of treatment.
The Conservative Mode Of Treatment
Some simple modifications can help relieve the pain of a bunionette, although they won’t get rid of the bumpy condition. The following remedies can be tried out:
- Shaving The Callus to decrease the protruding and irritating bumpy lesion
- Putting A Silicone Bunion Pad Over The Bunionette to relieve pain and prevent the bunion from rubbing against your footwear
- Wearing Flexible Shoes With A Wide Toe Box, avoiding narrow, pointed shoes and high heels
- Applying Ice Massage To The Affected Foot for 5 to 10 minutes up to 3 times per day
- Taking (NSAIDs) to bring down swelling and relieve pain
- Doing Light Workout like calf stretches twice per day
- Taking Corticosteroid Injections around your 5th toe joint to help alleviate swelling and discomfort
- Using A Custom-Made Shoe Insert to cushion the bunionette and prevent pain
The Surgical Mode Of Treatment
If the pain and swelling don’t subside and symptoms of an unacceptable degree are not relieved by conservative treatments or if normal shoes can’t be worn owing to the bump’s extra-large growth, surgery is generally the next suggested option. Bunionette removal surgery is an outpatient procedure, so that admission into and discharge from the podiatric center happen the same day.
Surgical procedures are determined by the type of bunionette deformity confronted with.
- Type 1 Lesions
- Can be treated with condylectomy and capsular plication only in the absence of any increased intermetatarsal angle (IMA)
- May be associated with a bursectomy or with nodule removal in patients with arthropathy
- Excision arthroplasty may be performed if the joint is severely arthritic
- Type 2 Lesions
- May respond positively to a mid-shaft rotational osteotomy
- Lateral distal condylectomy may be added if deemed suitable
- Type 3 Lesions of moderate degree
- May respond well to lateral condylectomy and distal metatarsal osteotomy if moderately present
- Oblique and chevron-type osteotomies are commonly performed
- Large deformities require a mid-shaft or proximal osteotomy
Whenever a bunionette deformity is treated with an osteotomy, the bone is often held and fixed straight with a steel wire, screw, or plate and screws, depending on the surgeon’s decision.
The Postsurgical Care & Precautions
- Postoperative dressings are used for 6 weeks.
- Dressings are changed frequently or as necessary to ensure cleanliness and dryness.
- The affected foot is to be kept elevated above the chest level to keep edema and pain at bay.
- Patients with mid-shaft and proximal osteotomy should be restricted to non-weight bearing stance for at least 6-7 weeks.
- Patients with more distal osteotomies are permitted to bear weight in a postoperative shoe or splint no sooner than 3-4 weeks after surgery.
- Crutches or a walker can be used to help you move around.
- Doing foot and ankle workout can help keep your joints flexible while your foot heals.
- Arranging for physiotherapy would aid in strengthening the operated as well as the surrounding soft tissues.
Full recovery can take up to 3 months. Swelling in the affected toe happens to be the last remnant of your bunionette issue and might take as long as a full year to get completely eliminated. Sometimes a bunionette can return after surgery, especially if narrow shoes are worn after surgery.
The Associated Complications
- Bacterial Infection In The Wound
- Damage To Nerves & Blood Vessels
- Excessive Bleeding From The Wound
- Blood Clot Formation
- A Bad Reaction To The Anesthesia
- Injured Nerves Around The 5th Toe
- Delayed Wound Or Bone Healing
- Possible Recurrence Of The Bunionette