This type of bunion or bump occurs on the outside of the foot over the 5th metatarsophalangeal joint (5th toe and 5th metatarsal joint).  It was given its name due to the fact that it occurred quite frequently in tailors who used to sit cross legged on hard surfaces which put a lot of pressure on the outsides of their feet.  It has the same symptoms as a regular bunion.  Whereas the big toe goes to the outside of the foot in a regular bunion, the 5th toe goes towards the inside of the foot, or towards the big toe in a tailor’s bunion.

The most frequent cause of a tailor’s bunion is shoes that are improperly fitted.  As the tapering toebox of most shoes pushes the 5th toe towards the 4th toe, it makes the end of the 5th metatarsal more prominent and consequently more susceptible to trauma, most commonly from the shoe.  Unfortunately most shoes available to consumers are not wide enough for the average foot, so it is no wonder that this condition occurs often.

Tailor’s bunion is seen often in flexible and flat feet (pronated feet), because the flexible foot has a tendency to spread out in the forefoot, a condition foot care providers call SPLAY FOOT.  The effect of pronation on the forefoot is a motion called abduction, which means the forefoot moves away from the midline of the body and this increases pressure on the outside of the 5th metatarsal.

Most Tailor’s bunions can be effectively treated conservatively by choosing a shoe that does not squeeze the forefoot.  If an individual has too much pronation, a foot bed or an orthotic should be worn to bring the forefoot into a position of adduction (towards the midline of the body), which decreases the pressure on the 5th metatarsal bone.  Because of an unwillingness to wear wider shoes or an inability to find appropriate wide shoes, many individuals undergo a tailor’s bunionectomy, which removes some of the 5th metatarsal head (end of the bone towards the toes) and slides the head of the 5th metatarsal towards the head of the 4th metatarsal, making the forefoot narrower and less likely to be rubbed by shoes. In some advanced cases, a wedge of bone is removed from the base or back of the 5th metatarsal bone to allow for more correction of a wide forefoot.  Undergoing this type of surgery before a concerted effort to find shoes wide enough for an individual’s forefoot, is one of the many types of unnecessary foot surgeries that occur daily in America.  Getting the right shoe, and being properly fitted is the best treatment for a tailor’s bunion deformity.