Surgery to correct a Tailor's bunion is a very successful means of ending the pain of this foot deformity. A Tailor's bunion forms when there is either a bone enlargement of the head of the 5th metatarsal (a long bone located on the outer side of the foot from the middle of the foot to the base of the little toe), or when the 5th metatarsal is angled too far outward. This prominent bone, located just behind the base of the little toe, can be irritated by tighter shoes and by the ground when barefoot. The skin over this bone prominence becomes inflamed, and a protective thick bursa may also form, leading to more pain. Surgery is indicated when conservative measures, such as wider shoes, padding, anti-inflammatory medications, and steroid injections, do not resolve the pain.
To correct the Tailors bunion, the surgeon must identify if the prominence is due to a bone enlargement, or due to an abnormal angle of the bone. The basic procedure involves a short incision over the outer top side of the foot just behind the little toe. If the bone is simply enlarged, a basic procedure is performed that shaves the bone down along the outer side of the 5th metatarsal head, and possibly the bottom if there is an abnormal enlargement there as well. If the problem lies in the angle of the bone, a cut needs to be made in the bone that allows it to move back over towards the rest of the foot, thereby reducing the prominence against the side of the foot. Where this cut is made is dependant on how great of angle the bone is positioned outward in. Minor angle increases can be corrected with a cut closer to the little toe, which heals easier. Larger angles require that the bone be cut further back towards the middle of the foot, which results in more instability during the healing process and may require more immobilization during the healing process. A screw, plate, wire, or pin is used to secure the bone cut in either case, and usually six weeks must pass before the bone is healed.
Recovery depends on which procedure was performed. Simple prominence, or 'bump', removals heal in about 3 or 4 weeks, with the use of a post-op shoe to protect the foot. Procedures that require bone cuts will need at least 6 weeks for the bone to heal, and may either require the use of a post-op shoe, a fracture boot, or a leg cast with crutches to keep the healing bone stable externally.