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Bunionette / Overlapping 5th Toe Deformity

- 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.  

Hohmann-Thomasen metatarsal osteotomy for tailor's bunion (bunionette).

Metatarsal head resection for bunionette: long-term follow-up.

Modified Coughlin procedure for surgical treatment of symptomatic tailor's bunion: a prospective followup study of 33 consecutive operations.