Tailor’s Bunion/Bunionette

[TheCougar]

Had to Google that site and it's as weird as I thought it might be.

I am not that adventurous. I can guess, though…

 

[Marbles]

Good timing on this thread, I don't have any pain from them, but my little toes are deformed freak's of nature.

I've gone to wider toe boxes on most shoes and will give the toe spacers a try as recommended by @Nickofthewoods

 

[Nickofthewoods]

Good luck to you guys. Wearing those spacers can be uncomfortable at first and takes some getting used to but if you stick with it for weeks or months I think you'll get similar positive results. For me it was my ski boots essentially squeezing the front of my feet which made the bones form the bunion in the first place. The spacers had the opposite effect. Fwiw I just used the gel spacers you can get at any general store.

Footwear doesn't have to be clown shoes either they just can't be causing you to feel pressure on the bunion area. My hunting boots are Lowa Tibets and I don't even need the wide version but some other footwear I do need the wide variation, it just depends on the fit.

 

[ztc92]

This was interesting to me as I’ve seen some patients in my practice with these bunions but never spent much time reading up on them or the surgeries available.

From a review of some general guidelines for orthopedics, it seems you’ve gotten sound advice so far. Try conservative measures first and then if that fails or the bunions are having too great an impact on you quality of life, consider surgery.

Assuming you weren’t born with them, the cause of these bunions seems to generally be footwear that compresses the forefoot or walking in a way that puts more force on the outside of the foot.

Regarding surgery, there looks to be 3-4 common surgical techniques but they aren’t created equal. What I mean by that is there is a classification system used to classify the anatomic cause of the bunion and associated changes to the bone/joint. The cause of the bunion is what determines the best surgical technique. I’m oversimplifying here, but from what I’ve read, type 1 is excessive bone growth, type 2 is due to bowing/curving of the bone and type 3 is due to the metatarsal (bone leading to toe) pointing outwards. Each of these types has its own surgical treatment since the anatomy causing the bunion varies and so too does the fix. This is the reason for the multiple surgeries, it’s not as simple as “this surgeon prefers this method and it’s better because…”.

All of that to say, if it was my feet, I would exhaust all conservative measures before proceeding with surgery. If I did have an interest in surgery, I would start with some weight bearing x-rays and have a qualified specialist (ideally an orthopedic surgeon who has completed a fellowship in foot/ankle surgery) go over the X-rays with me and help me decide the best approach to surgery based on what my x-rays showed.

 

[ztc92]

For those curious, here is a type 1 example showing extra bone formation:



Here is a type 2 with a curve in the bone:



And here is a type 3 where the bone is just pointing towards the outside of the foot:




Hopefully that provides some context on why/how the types can vary and why they require different types of surgeries to fix them.

 

[TheCougar]

For those curious, here is a type 1 example showing extra bone formation:

View attachment 851929

Here is a type 2 with a curve in the bone:

View attachment 851930

And here is a type 3 where the bone is just pointing towards the outside of the foot:

View attachment 851931


Hopefully that provides some context on why/how the types can vary and why they require different types of surgeries to fix them.

I believe I am a type 3. I am going to give the non-surgical route a shot.