pathology: tailor’s bunion

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tailor’s bunion

Definition of

Tailor’s bunion is a typical complication of splayfoot. The 5th ray moves laterally into a valgus position, but bends clearly medially in the metatarsophalangeal joint area. The little toe is in varus position. The lateral deviation of the metatarsophalangeal joint area leads to pressure against the footwear and the formation of painful pressure points with calluses. It is not uncommon for an exostosis to form. In terms of etiology and symptoms, the tailor’s bunion is the analog of hallux valgus, even if it is less common. Surgical intervention may also be necessary here. The ability of hallux valgus and metatarsalgia to shift the rolling behavior of the foot laterally to avoid pain is permanently disrupted, resulting in even more severe pain avoidance patterns for the musculoskeletal system. This disorder was given the name “ tailor’s bunion “ because in earlier times a disorder pattern with painful callus formation, exostosis and varus position of the little toe often developed in tailors. However, the aetiology with deviation of the 5th ray will not have been present.

Cause

  1. Splayfoot
  2. Rare: prolonged and frequent sitting cross-legged (altered etiology: no deviation of the 5th ray)

Predisposing

  1. Tibialis posterior syndrome (PTTD)
  2. Frequent standing for long periods
  3. Overloading the foot
  4. idiopathic connective tissue weakness

Symptoms

  1. Painful pressure points at the base of the little toe and in the metatarsophalangeal joint area
  2. Conspicuous varus position of the little toe, possibly with pressure against the 4th toe; then formation of painful pressure points, blisters and corns
  3. painful bursitis
  4. Discomfort when walking

Therapy

  1. Strictly avoid tight shoes and high heels, instead wear wide, flat shoes
  2. Padding in the shoe if necessary
  3. Insoles against splayfoot
  4. Walking barefoot
  5. Foot gymnastics
  6. If conservative therapy fails, a chevron osteotomy may be necessary

Asana practice

Due to the predominant development as a complication of splayfoot, see the treatment of splayfoot.