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At least 19 recordsLinked to original sources
PubMedDate not supplied

Tailor's bunion: a review.

The tailor's bunion is a painful bony prominence on the lateral aspect of the fifth metatarsal head that occurs in many individuals, but seldom causes symptoms. This article reviews the current literature regarding the presentation, etiology, and management of the tailor's bunion. The first line of management should be conservative, with advice on shoe wear. Orthotics may be useful if a symptomatic tailor's bunion results from excessive subtalar joint pronation. Operative management, indicated when symptoms are not controlled nonoperatively, aims to decrease foot width and the prominence of the tailor's bunion. Procedures can be grouped into resections and distal, diaphyseal, and proximal osteotomies. A distal osteotomy is recommended if medial translation of the head for one-third of the width of the metatarsal shaft produces a normal fourth-fifth intermetatarsal angle. A proximal osteotomy can be performed in the face of larger deformities. The management of recurrent tailor's bunion is still controversial. If the recurrence is due to under-correction, or if the initial procedure was not the best suited to that particular patient, then revision surgery may be helpful, after the cause of the failure has been established. Although unpopular, resection should be considered as the final salvage procedure.

Foot Deformities↗
PubMed1996

Tailor's bunion. Is fixation necessary?

Tailor's bunion or bunionette are terms that describe a pathologic enlargement occurring laterally on the fifth metatarsophalangeal joint. Regardless of the etiology that precipitates the deformity, the resulting abnormal protrusion of soft tissue or bone can result in pain for the patient. Symptoms can range from mild discomfort to severe, debilitating pain. The patient may present with pain dorsolaterally, laterally, or plantarly. The symptoms are mechanically induced, and are often associated with hyperkeratotic lesions and adventitious bursae. Patients complain most often that they cannot find comfortable shoes. The authors compare the effectiveness of fixated versus nonfixated distal osteotomies of the fifth metatarsal for the correction of tailor's bunion. This study shows that fixation can help control postoperative dorsal displacement of the fifth metatarsal capital fragment (p < 0.0001) and produce less shortening of the metatarsal resulting in fewer complications.

Adolescent↗
PubMed2006

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

BACKGROUND: Symptomatic tailor's bunion is a painful osseous and soft-tissue prominence at the lateral aspect of the fifth metatarsal head. If conservative treatment fails, surgery is necessary to correct the deformity and to relieve the symptoms. The "Coughlin" procedure is an established corrective diaphyseal realignment osteotomy. The purpose of this study was to analyze the results of a modification of the Coughlin procedure in a series of 24 consecutive patients. METHODS: Between October, 1999, and August, 2002, we performed a modified Coughlin procedure for painful tailor bunions in 24 patients (33 feet). An additional bunionectomy was done only if the fifth metatarsal head remained prominent after the osteotomy (20 feet). The average age of the patients was 45 years. All patients were evaluated preoperatively and postoperatively using the AOFAS forefoot score, and the correction of the fourth-fifth intermetatarsal angle was assessed on full weightbearing dorsoplantar radiographs. The average followup was 24 months for objective and 39 months for the subjective results. RESULTS: There were no intraoperative and postoperative complications. The mean AOFAS score increased from 55 points preoperatively to 95 points at followup. At longest followup the subjective results were rated as good or excellent in 22 patients (97%). No difference in subjective patient satisfaction was seen whether bunionectomy was done or not. The mean fourth-fifth intermetatarsal angle improved from 10.4 degrees preoperatively to 1 degree at followup. Six patients (18%) required screw removal which was carried out on an outpatient basis under local anesthesia. CONCLUSION: The modified Coughlin procedure is a technically safe and reliable procedure for treatment of painful tailor's bunion. In our experience, it yields good or excellent results with high patient satisfaction and a low complication rate. Internal screw fixation leads to stable bony fusion with full weightbearing immediately postoperatively and is associated with a relatively low rate of implant removal.

Adolescent↗
PubMedDate not supplied

L-osteotomy with absorbable fixation for correction of tailor's bunion.

A procedure is described for correction of tailor's bunions. The L-osteotomy is a transpositional neck osteotomy that is inherently stable. Fixation of choice is the Orthosorb absorbable pin (Johnson & Johnson Orthopedics, Raynham, MA). A retrospective study was undertaken of 12 patients who underwent 21 osteotomies. All patients believed that the pain and deformity associated with the tailor's bunion were resolved by the surgery. One asymptomatic nonunion, and one asymptomatic malunion occurred. At final follow-up, radiographic lucency at the Orthosorb pin sites persisted in 62% of the feet.

Adolescent↗
PubMed2001

Tailor's bunion: results of a scarf osteotomy for the correction of an increased intermetatarsal IV/V angle. A report on ten cases with a 1-year follow-up.

INTRODUCTION: The aim of this study was to analyze clinical and radiological results of scarf osteotomy for the correction of an increased intermetatarsal IV/V angle in patients with symptomatic tailors bunion. PATIENTS AND METHODS: Between 1997 and 1998, we performed a scarf osteotomy for the correction of an increased intermetatarsal IV/V angle (IMA) in ten cases. The indication was a painful prominence of the fifth metatatarsal with an increased IMA. Fixation of the osteotomy was performed with two 1.7-mm titanium miniscrews. Mobilization was allowed with full weight-bearing, with a forefoot relief orthosis. Clinical results were evaluated with the forefoot scoring system (ffss). The determination of the IMA was performed with weight-bearing dorsoplantar radiographs. RESULTS: All osteotomies healed within the first 6 postoperative weeks. Removal of the screws was not necessary in any case. The mean preoperative ffss was 29.5 points. At the last follow-up, the mean value of the ffss was 73 points and no patient presented a painful prominence above the fifth metatarsal head. The mean IMA was reduced significantly from 10.3 to 6.8 degrees. DISCUSSION: The scarf osteotomy is an adequate surgical procedure for the correction of an increased IMA in patients with symptomatic tailor's bunion.

Adult↗
PubMed1990

Pathology of the fifth ray, including the tailor's bunion deformity.

Pathology of the fifth ray has been reviewed with emphasis on the tailor's bunion. Based on a thorough radiographic analysis, the bunionette has been grouped into four types, and surgical criteria has been proposed. The goal of this study is to provide guidelines that may enable both podiatric and orthopedic surgeons to recognize the types of tailor's bunions and assist in the selection of an appropriate surgical procedure.

Adult↗
PubMedDate not supplied

Neuromas associated with tailor's bunion.

The purpose of this paper is to present to the physician a common clinical problem associated with tailor's bunion, a probable traumatic neuroma of the proper digital branch of the superficial division of the lateral plantar nerve. Many of the patients who presented to the authors with tailor's bunion also exhibited a traumatic neuroma. The authors discuss this clinical problem, its treatment, and its eradication.

Foot↗
PubMed1991

Distal oblique osteotomy for tailor's bunion.

Thirty-six patients with a total of 50 symptomatic tailor's bunions were evaluated clinically, radiographically, and subjectively, both before and after a distal oblique osteotomy procedure was performed. Thirty-four of 36 patients were satisfied with pain relief. Radiographic measurements derived from this study were consistent with those of other studies. Avascular necrosis, nonunions, or neuroma formation were not encountered in this study. The significant advantages of this procedure are its simplicity, safety, and predictability. The procedure does not require internal fixation or postoperative immobilization.

Adolescent↗
PubMedDate not supplied

Oblique metaphyseal osteotomy for the correction of Tailor's bunions: a 3-year review.

This study presents a 3-year review of patients undergoing a fifth metaphyseal osteotomy for the treatment of Tailor's bunions. Postoperative analysis consisted of patient's subjective appraisal, activity level, physical examination, and radiographic studies. The fifth metaphyseal osteotomy, in this study, reduced lateral deviation and fourth-fifth intermetatarsal angles to less than or equal to normal values, while decreasing intermetatarsal head distance and returning the fifth metatarsophalangeal joint to congruency. Patient satisfaction was high while providing a low incidence of transfer lesions. This manuscript demonstrates the fifth metaphyseal osteotomy to be a viable treatment for Tailor's bunions.

Adolescent↗
PubMedDate not supplied

Tailor's bunion: clinical evaluation and correction by distal metaphyseal osteotomy with cortical screw fixation.

Fifth metatarsal distal metaphyseal osteotomy represents a very common surgical procedure performed for tailor's bunion deformity. The authors advocate using a cortical bone screw for fixation device offers many advantages over conventional devices (i.e., Kirschner wire). The purpose of this paper is to offer a means to thoroughly evaluate tailor's bunion deformity clinically, biomechanically, and radiographically. This will allow the podiatric surgeon to choose a procedure of choice to correct the deformity. The technique of fifth metatarsal distal metaphyseal osteotomy with cortical bone screw fixation using AO4 principles is fully described.

Biomechanical Phenomena↗
PubMedDate not supplied

Long oblique distal osteotomy of the fifth metatarsal for correction of tailor's bunion: a retrospective review.

A long-term retrospective review of a long oblique distal osteotomy of the fifth metatarsal for correction of a tailor's bunion deformity is presented. The technique, results, and follow-up of this procedure are described. The long oblique distal osteotomy was performed on 25 feet on 16 patients. Follow-up ranged from 11 to 110 months with an average of 64.4 months. The average preoperative intermetatarsal 4-5 angle and lateral deviation angle improved from 10.88 degrees and 4.24 degrees, respectively, to 5.52 degrees and -4.24 degrees postoperatively, respectively. A modified scoring scale for lesser metatarsal procedures was used, showing an average postoperative score of 94 out of 100 possible points. Subjectively, 96% (24 of 25) of feet that underwent surgery were rated as excellent or good. Complications included one patient with paresthesias, one soft-tissue infection, and 2 patients had irritation from screws. The authors conclude that the long oblique distal osteotomy is a viable alternative in the correction of tailor's bunion deformity.

Adolescent↗
PubMedDate not supplied

Metaphyseal osteotomy for the treatment of tailor's bunions.

There have been many surgical approaches described for the surgical treatment of tailor's bunions. The authors have been using a procedure that addresses both an elevated fourth to fifth intermetatarsal angle and an elevated lateral deviation angle, for the past 3 years. The metaphyseal osteotomy provides reliable correction of these two abnormalities and allows for uncomplicated rigid fixation.

Adult↗
PubMedDate not supplied

Surgical correction of tailor's bunion with resection of fifth metatarsal head and silastic sphere implant: an 8-year follow-up study.

This paper introduces a fifth metatarsal head surgery with silicone sphere implant to correct tailor's bunion deformities and prevent digital retraction that may occur after fifth metatarsal head resection. The authors present an 8-year follow-up of 35 patients who underwent 50 procedures. The authors had an 84% success rate, but they submit that this procedure is not indicated in every case of tailor's bunion.

Follow-Up Studies↗
PubMed1989

Triplanar closing base wedge osteotomy for tailor's bunion.

The authors discuss mathematical evaluations when considering base wedge osteotomies to correct a tailor's bunion. A review of the literature is presented in order to use clinical results when algebraic and trigonometric functions are discussed.

Hallux Valgus↗
PubMed1989

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

We used subcapital displacement osteotomy of the fifth metatarsal bone and peg-and-hole fixation to treat a tailor's bunion (bunionette) in forty-four feet (twenty-seven patients). The result was good in 86 per cent, fair in 9 per cent, and poor in 5 per cent. All but one of the patients were satisfied with the result. The average medial displacement of the head of the fifth metatarsal was five millimeters. In all feet, secure union was noted in five weeks, and no patient had osteonecrosis of the head of the fifth metatarsal.

Adolescent↗