Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
권호 표지

Bunionette Deformity

소건막류

  • Kim, Yoon-Chung (Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Ahn, Jae Hoon (Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
  • 김윤정 (가톨릭대학교 의과대학 서울성모병원 정형외과) ;
  • 안재훈 (가톨릭대학교 의과대학 서울성모병원 정형외과)
  • Received : 2013.01.18
  • Accepted : 2013.02.14
  • Published : 2013.03.15
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Abstract

The bunionette, or a 'tailor's bunion', is a lateral bony prominence of the fifth metatarsal head. A bony deformity itself rarely causes symptom but if a painful inflammation of the overlying soft tissue is accompanied, it needs treatment. Conservative care using a shoe modification, padding, or orthosis is effective in most cases. Surgical management is indicated when the conservative methods have failed to improve symptoms, and the techniques include exostectomy, metatarsal osteotomies (distal, diaphyseal, or proximal), metatarsal head resection or fifth ray resection. We reviewed the etiology, clinical features, radiographic classification, nonoperative and operative treatments of the bunionette.

Keywords

References

  1. Davies H. Metatarsus quintus valgus. Br Med J, 1:664-5, 1949.
  2. Cohen BE, Nicholson CW. Bunionette deformity. J Am Acad Orthop Surg, 15(5):300-7, 2007. https://doi.org/10.5435/00124635-200705000-00008
  3. Ajis A, Koti M, Maffulli N. Tailor's bunion: a review. J Foot Ankle Surg, 44(3):236-45, 2005. https://doi.org/10.1053/j.jfas.2005.02.005
  4. Koti M, Maffulli N. Bunionette. J Bone Joint Surg, 83-A: 1076-82, 2001.
  5. Baumhauer JF, DiGiovanni BF. Osteotomies of the fifth metatarsal. Foot Ankle Clin, 6:491-8, 2001. https://doi.org/10.1016/S1083-7515(03)00109-8
  6. Coughlin MJ. Treatment of bunionette deformity with longitudinal diaphyseal osteotomy with distal soft tissue repair. Foot Ankle, 11:195-203, 1991. https://doi.org/10.1177/107110079101100402
  7. De Lint JA, Wijffels NAT. The oblique diaphyseal osteotomy for bunionette. Foot and Ankle Surg, 4:99-104, 1998. https://doi.org/10.1046/j.1460-9584.1998.00094.x
  8. Diebold PF. Basal osteotomy of the fifth metatarsal for the bunionette. Foot Ankle, 12:74-9, 1991. https://doi.org/10.1177/107110079101200203
  9. Kitaoka HB, Holiday AD Jr. Lateral condylar resection for bunionette. Clin Orthop Relat Res, 278:183-92, 1992.
  10. Wu KK. Surgery of the foot. Philadelphia, Lea and Febiger: 151-3, 1986.
  11. Buchbinder IJ. DRATO procedure for tailors bunion. J Foot Surg, 21:177-80, 1982.
  12. Diebold PF, Bejjani FJ. Basal osteotomy of the fifth metatarsal with intermetatarsal pinning: a new approach to tailor's bunion. Foot Ankle, 8:40-5, 1987. https://doi.org/10.1177/107110078700800109
  13. Brown JE. Functional and cosmetic correction of metatarsus latus (splayfoot). Clin Orthop, 14:166-70, 1959.
  14. Dickson F, Diveley RL. Hallux in functional disorders of the foot. 3rd ed. Philadelphia, JB Lippincott: p 230, 1953.
  15. DuVries HL. Surgery of the foot. 4th ed. St. Louis, CV Mosby: 273-7, 1978.
  16. Lelievre J. L'exostose de la 5 metatarsienne. Le Concours Medical, 78: 4815-6, 1956.
  17. Sgarlato T. Compendium of podiatric biomechanics. San Francisco, California College of Podiatric Medicine: p 381, 1971.
  18. Root ML, Orien WP, Weed JH. Normal and abnormal function of the foot. In Clinical Biomechanics. vol. 2. Los Angeles, Clinical Biomechanics Corp: 249-50, 425-42, 1977.
  19. Salmons S. Muscle. In Gray's anatomy. chap 7, 38th ed. Edinburgh, Churchill Livingstone: p 894, 1995.
  20. Kelikian AS. Sarrafian's anatomy of the foot and ankle. 3rd ed. Philadelphia, Lippincott: 565-74, 2011.
  21. Yancey HA. Congenital lateral bowing of the fifth metatarsal. Clin Orthop, 62:203-5, 1969.
  22. Haber JH, Kraft J. Crescentic osteotomy for metatarsal head. J Foot Surg, 19:66-7, 1980.
  23. Fallat LM, Buckholz J. An analysis of the tailor's bunion by radiographic and anatomical display. J Am Podiatr Assoc, 70:597-603, 1980. https://doi.org/10.7547/87507315-70-12-597
  24. Fallat LM. Pathology of the fifth ray, including the tailor's bunion deformity. Clin Podiatr Med Surg, 7:689-715, 1990.
  25. Steel MW 3rd, Johnson KA, DeWitz MA, Ilstrup DM. Radiographic measurements of the normal adult foot. Foot Ankle, 1:151-8, 1980. https://doi.org/10.1177/107110078000100304
  26. Nestor BJ, Kitaoka HB, Ilstrup DM, Berquist TH, Bergmann AD. Radiologic anatomy of the painful bunionette. Foot Ankle, 11:6-11, 1990. https://doi.org/10.1177/107110079001100102
  27. Gerbert J, Sgarlato TE, Subotnick SI. Preliminary study of a closing wedge osteotomy of the fifth metatarsal for correction of tailor's bunion deformity. J Am Podiatr Assoc, 62:212, 1972. https://doi.org/10.7547/87507315-62-6-212
  28. Steinke MS, Boll KL. Hohmann-Thomasen metatarsal osteotomy for tailor's bunion (bunionette). J Bone Joint Surg Am, 71:423-6, 1989. https://doi.org/10.2106/00004623-198971030-00018
  29. Mann RA, Mann JA. The bunionette deformity. Instr Course Lect, 53: 303-9, 2004.
  30. Radl R, Leithner A, Koehler W, Scheipl S, Windhager R. The modified distal horizontal metatarsal osteotomy for correction of bunionette deformity. Foot Ankle, 26:454-7, 2005. https://doi.org/10.1177/107110070502600605
  31. Leach RE, Igou R. Metatarsal osteotomy for bunionette deformity. Clin Orthop Relat Res, 100:171-5, 1974.
  32. Sponsel KH. Bunionette correction by metatarsal osteotomy: Preliminary report. Orthop Clin North Am, 7:809-19, 1976.
  33. Kitaoka HB, Leventen EO. Medial displacement metatarsal osteotomy for treatment of painful bunionette. Clin Orthop Relat Res, 243:172-9, 1989.
  34. Kitaoka HB, Holiday AD Jr, Campbell DC 2nd. Distal chevron metatarsal osteotomy for bunionette. Foot Ankle, 12: 80-5, 1991. https://doi.org/10.1177/107110079101200204
  35. Diebold PF. Bunionette deformity: oteotomies of the fifth metatarsal bone. In An Atlas of Foot and Ankle Surgery. London, II Mosby: 1393-8, 1998.
  36. Frankel JP, Turf RM, King B. Tailor's bunion: clinical evaluation and correction of distal metaphyseal osteotomy with cortical screw fixation. J Foot Surg, 28:237-43, 1989.
  37. Mercado OA. An atlas of foot surgery. vol. 1. Illinois, Carlando Press: 165-9, 1979.
  38. Yu GV, Ruch JA, Smith TF. Deformity and surgery of the fifth ray. In Comprehensive Textbook of Foot Surgery. Baltimore, Williams & Wilkins: 114-32, 1987.
  39. Coughlin MJ. Etiology and treatment of the bunionette deformity. Instr Course Lect, 39:37-48, 1990.
  40. London BP, Stern SF, Quist MA, Lee RK, Picklesimer EK. Long oblique distal osteotomy of the fifth metatarsal for correction of tailor's bunion: a retrospective review. J Foot Ankle Surg, 42:36-42, 2003. https://doi.org/10.1016/S1067-2516(03)70051-9
  41. Ahn JH, Kim HY, Kang JW, Choy WS, Kim YI. Treatment of bunionette deformity with diaphyseal oblique osteotomy. J Korean Foot Ankle Soc, 12(1):31-5, 2008.
  42. Bishop J, Kahn A 3rd, Turba JE. Surgical correction of the splayfoot: The Giannestras procedure. Clin Orthop Relat Res, 146:234-8, 1980.
  43. Okuda R, Kinoshita M, Morikawa J, Jokotu T, Abe M. Proximal dome shaped osteotomy for symptomatic bunionette. Clin Orthop Relat Res, 396:173-8, 2002. https://doi.org/10.1097/00003086-200203000-00026
  44. Shrum DG, Sprandel DC, Marshall H. Triplanar closing base wedge osteotomy for tailor's bunion. J Am Podiatr Assoc, 793:124-7, 1989.
  45. Estersohn HS, Scherer PR, Bogdan R. A preliminary report on open wedge osteotomy of the fifth metatarsal. Arch Podiatr Med Foot Surg, 1:317-27, 1974.
  46. McKeever DC. Excision of the fifth metatarsal head. Clin Orthop Relat Res, 13:321-2, 1959.
  47. Kitaoka HB, Holiday AD Jr. Metatarsal head resection for bunionette: Long-term follow-up. Foot Ankle, 11:345-9, 1991. https://doi.org/10.1177/107110079101100601
  48. Mann RA, Coughlin MJ. Keratotic disorders of the plantar skin. In Surgery of Foot and Ankle. 6th ed. St. Louis, Mosby: 413-64, 1993.
  49. Keating SE, DeVincentis A, Goller WL. Oblique fifth metatarsal osteotomy: A follow-up study. J Foot Surg, 21: 104-7, 1982.
  50. Shereff MJ, Yang QM, Kummer FJ, Frey CC, Greenidge N. Vascular anatomy of the fifth metatarsal. Foot Ankle, 11: 350-3, 1991. https://doi.org/10.1177/107110079101100602