- A bunionette is a bony prominence at the base of the fifth toe — essentially a bunion on the outside of the foot.
- It develops from the same shoe pressure and structural mechanics that cause regular bunions.
- Mild bunionettes respond to wider shoes, padding, and custom orthotics.
- Surgical correction is straightforward for symptomatic cases — typically a small osteotomy that narrows the forefoot.
- Often coexists with a regular bunion on the inside of the same foot.
What are a bunionette deformity?
A bunionette (also called a tailor's bunion) is a bony bump on the outside of the foot at the base of the little toe, often with the toe drifting inward. It is essentially the mirror image of a regular bunion — same mechanism, opposite side of the foot. The name 'tailor's bunion' comes from the historical observation that tailors who sat cross-legged developed pressure on this spot.
Bunionettes develop from a combination of foot structure (a naturally splayed forefoot or a prominent fifth metatarsal head) and shoes that compress the forefoot. Symptoms include a visible bump, painful callus formation over the prominence, and difficulty with shoe fit. Many patients have both a bunion and a bunionette on the same foot.
At NES we treat most bunionettes conservatively first — wider footwear, padding, custom orthotics, and callus management. Surgical correction is an option for patients whose symptoms persist or who can't find shoes that fit. The surgery is straightforward and recovery is fast.
See it in motion
Animations licensed from ViewMedica · Swarm Interactive
What it feels like
Bunionettes are usually visually obvious. Common symptoms:
- A bony bump on the outside of the foot at the base of the little toe
- Pain and callus formation over the bump where the shoe rubs
- Pain with closed shoes, especially narrow or fashionable footwear
- Difficulty finding shoes that fit comfortably
- Sometimes the little toe drifts inward toward the fourth toe
- Burning or sharp pain at the bump after long days on your feet
Why it develops
Bunionettes form from a combination of structural and external factors:
- Wearing narrow, pointed, or high-heeled shoes that squeeze the forefoot
- Genetic foot structure — splayed forefoot or naturally prominent fifth metatarsal
- Flat feet with overpronation that loads the outside of the forefoot
- High arches that throw more pressure onto the outer ball of the foot
- Coexisting bunion deformity on the same foot
How we diagnose a bunionette deformity
Diagnosis is clinical — the deformity is obvious. Weight-bearing X-rays confirm the type and rule out other forefoot pathology.
Non-surgical care
Conservative care manages most bunionettes successfully:
- Wider, deeper toe-box shoes (the single biggest lever)
- Pads or shields over the bump to reduce shoe friction
- Callus debridement at routine foot care visits
- Custom orthotics to correct the foot mechanics driving outer-forefoot overload
- Toe spacers or splints in selected cases
- Anti-inflammatory medication during flares
Surgical care
Surgery is reserved for symptomatic bunionettes that don't improve with conservative care. The procedure is straightforward and recovery is fast.
- Distal fifth metatarsal osteotomy (Weil-type or chevron-type cut) — for prominent heads
- Diaphyseal fifth metatarsal osteotomy — for bowed shafts
Bunionette surgery is typically done as a day procedure with weight-bearing in a stiff post-op shoe immediately. Return to athletic shoes at 4–6 weeks and full activity at 8–12 weeks. Often performed simultaneously with bunion correction when both are present.
When to see a specialist
- A painful bump on the outside of the foot that's changing your shoe options
- Recurrent callus over the fifth metatarsal head
- A bump that's grown over time
- Coexisting bunion and bunionette in the same foot
Bunionettes are treated by every NES podiatrist. Surgical correction is most often performed by Dr. Denny Le, Dr. Thomas Melillo, and Dr. Yama Dehqanzada, particularly when combined with bunion correction.