Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

What Is a Bunionette?

A bunionette — also called a tailor bunion — is a bony prominence on the outer (lateral) side of the foot at the fifth metatarsal head, analogous to a regular bunion at the first metatarsal head but located at the base of the small toe. The term tailor bunion comes from the historical observation that tailors, who sat cross-legged for long hours with the outer foot in contact with the floor, commonly developed this prominence. The condition causes pain, redness, and difficulty with footwear on the outer edge of the foot at the base of the little toe.

At Balance Foot & Ankle, we treat bunionettes in patients throughout Southeast Michigan with both conservative care and surgical correction.

Causes and Types of Bunionette

Bunionettes develop from three distinct structural abnormalities of the fifth metatarsal. Type 1 involves an enlarged fifth metatarsal head — the bone itself is wider than normal. Type 2 involves an abnormal lateral bow of the fifth metatarsal shaft, which causes the head to protrude laterally despite a normal head size. Type 3 — the most common — involves an increased angle between the fourth and fifth metatarsals (the 4-5 intermetatarsal angle), which causes the fifth metatarsal to diverge laterally away from the fourth.

Narrow-toed or tight footwear significantly worsens symptoms from any bunionette type by compressing the lateral prominence, but footwear does not cause the underlying structural deformity. Genetic predisposition, elevated forefoot pressure, and biomechanical factors contribute to bunionette development.

Symptoms

Pain and tenderness over the lateral fifth metatarsal head are the primary symptoms. A reddened, thickened bursa over the prominence is common — the body forms a fluid-filled cushion in response to chronic pressure. The small toe may deviate medially (inward) as the deformity progresses. Wearing any enclosed shoe that compresses the outer forefoot produces significant discomfort. The pain is often described as burning or aching and worsens throughout the day with activity.

Conservative Treatment

Conservative management focuses on reducing pressure on the bunionette prominence. Wide toe box footwear with a soft, accommodating upper that does not compress the lateral forefoot is the primary footwear recommendation. Bunionette pads placed over the prominence distribute pressure away from the peak. Custom orthotics with lateral forefoot offloading reduce pressure under the fifth metatarsal head. Corticosteroid injection into the fifth metatarsal head bursa reduces acute inflammatory pain.

Surgical Correction

When conservative management fails to provide adequate pain relief, bunionette surgery is effective. The surgical approach depends on the anatomic type. Lateral condylectomy — shaving the prominent lateral surface of the fifth metatarsal head — is appropriate for Type 1 deformity. Distal fifth metatarsal osteotomy corrects the divergent metatarsal angle in Type 3 deformity by creating a controlled bone cut and shifting the fifth metatarsal head medially. Diaphyseal osteotomy corrects Type 2 lateral bowing. Recovery involves protective weight bearing in a surgical shoe for 4 to 6 weeks and return to normal footwear at 6 to 8 weeks.

If you have persistent outer foot pain from a bunionette that limits your footwear and daily activity, contact Balance Foot & Ankle for evaluation. We serve Southeast Michigan with same-week appointments.

Frequently Asked Questions

What causes a tailor’s bunion?

Tailor’s bunions result from genetic bone structure (prominent fifth metatarsal head), abnormal splaying of the forefoot, and footwear that compresses the outer foot. Women and those with wide forefeet are at higher risk.

How do I treat a bunionette without surgery?

Wider toe-box shoes, bunionette pads or moleskin, custom orthotics to redistribute pressure, and avoiding high heels or pointy shoes resolve pain in most cases. Icing after activity and NSAIDs help flares.

What is the recovery time after bunionette surgery?

Most bunionette osteotomies allow weight-bearing in a post-op shoe within 2 weeks. Return to regular shoes typically at 6-8 weeks, with complete recovery and return to athletic activity at 3-4 months.

Bunionette (Tailor’s Bunion) Treatment in Michigan

A bunionette or tailor’s bunion causes painful enlargement at the base of the little toe that can make footwear uncomfortable. Dr. Tom Biernacki at Balance Foot & Ankle offers both conservative management and minimally invasive surgical correction at our Howell and Bloomfield Hills offices.

Learn About Our Bunion & Bunionette Treatment | Book Your Appointment | Call (810) 206-1402

Clinical References

1. Coughlin MJ. “Treatment of bunionette deformity with longitudinal diaphyseal osteotomy with distal soft tissue repair.” Foot and Ankle International. 2000;21(1):10-22.
2. Giannini S, et al. “Minimally invasive surgery for forefoot deformities: bunionette correction.” Foot and Ankle Clinics. 2014;19(3):361-373.
3. Leach RE, Igou R. “Metatarsal osteotomy for bunionette deformity.” Clinical Orthopaedics and Related Research. 1974;100:171-176.

Your Board-Certified Podiatrists

Dr. Tom Biernacki, DPM

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Dr. Carl Jay, DPM

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Dr. Daria Gutkin, DPM

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Dr. Tom Biernacki, DPM

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Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.