Houston Methodist. Leading Medicine

Foot FAQ


Talk about aching feet. I have bunions on both sides of my feet (lucky me). I've seen other people with big toe bunions but never little toe bunions. Am I unusual?


It sounds like you have both bunions and bunionettes. Bunionettes are not as common as bunions. In a recent study on this topic, surgeons found only 30 cases in 21 patients (so some people had bunionettes on both feet) over a 10 year period of time. With a bunion of the big toe, a large bump seems to grow out of the side of the great toe. But in fact what is happening is that the two bones that meet to form the big toe joint angle away from each other. A bump we call a bunion forms at the end of the metatarsal (long bone of the toes). The bunion that develops is actually a response to the pressure from the shoe on the point of this angle. At first the bump is made up of irritated, swollen tissue that is constantly caught between the shoe and the bone beneath the skin. As time goes on, the constant pressure may cause the bone to thicken as well, creating an even larger lump to rub against the shoe. A bunionette is similar to a bunion, but it develops on the little toe side of the foot where the small toe connects to the foot. This area is called the metatarsophalangeal joint, or MTP joint. A bunionette here is sometimes referred to as a tailor's bunion. It formed because tailors once sat cross-legged all day with the outside edge of their feet rubbing on the ground. This produced a pressure area and callus at the bottom of the fifth toe. Today a bunionette is most likely caused by an abnormal bump over the end of the fifth metatarsal (the metatarsal head) rubbing on shoes that are too narrow. Some people's feet widen as they grow older, until the foot splays. This can cause a bunion on the big toe side of the foot and a bunionette on the little toe side if they continue to wear shoes that are too narrow. The constant pressure produces a callus and a thickening of the tissues over the bump, leading to a painful knob on the outside of the foot. Bruno Magnan, MD, et al. Percutaneous Distal Osteotomy of the Fifth Metatarsal for Correction of Bunionette. In The Journal of Bone and Joint Surgery. November 16, 2011. Vol. 93-A. No. 22. Pp. 2116-2122.

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