Bunionette

Nev Davies

Reading Children’s Orthopaedic Unit

What is an Bunionette?

This uncommon condition causes a prominent swelling and bump at the base and outside of the little toe.

What are the symptoms of Bunionette?

The main concern is excessive rubbing and redness associated with the bump. As the bunionette gets bigger it can rub more, causing pain, hard skin and blistering, as well as difficulties getting shoes to fit. It usually starts to cause problems after the age of 10 years.

What causes this?

The shape of the long toe (metatarsal) causes the bump. We do not know exactly what causes bunionette but it can affect several generations of the same family, which implies that it is sometimes passed on from parent to child (inherited).

What is the natural history of this condition?

If the foot remains asymptomatic (no symptoms) and pain free, we tend to observe and leave well alone. We would encourage moisturisation with cream after baths and wide fitting shoes for comfort.

How can it be treated?

Treatment options are quite binary.

Option A. Leave alone and observe: we tend to do this in asymptomatic or patients who present younger than their teenage years

Option B. Surgery to straighten the toe: the operation is done under a general anaesthetic as a day case procedure. At the time of consent, we would discuss the procedure in detail with you, including the benefits and the risks of the surgery, as well as the post-operative care.  Please see the separate information leaflet regarding surgery.

Bunionette Surgery

What does the operation involve?

The operation is done under a general anaesthetic as a day case procedure. We also numb the toe with local anaesthetic. It is quite a big operation through a medium sized scar along the side of the toe. The bump is shaved off and the bone is cut and reset in a much straighter position. It is held with tiny orthopaedic screws. This is done under X ray control during the surgery. Dissolvable stitches are used as well as paper stitches and a big wool and crepe dressing is applied.

Before surgery  After surgery    

What is the aftercare?

It is extremely important to elevate the foot for 72 hours after the operation. This helps the swelling settle and aid healing. A temporary splint (half plaster) is used with a heel-walking shoe. Crutches are useful to get around, but not essential, particularly at school. Patients are seen in clinic around 2 weeks after the operation to check the scar is healing, to redress the wound and to obtain an x ray.  Most patients would slowly wean into a shoe with a nice wide toe box at this stage. Return to sports and activities is allowed after a final check and x ray at about 8 weeks.

What are the success rates?

The vast majority of families are very happy with the result. There is always a small chance of problems, but this is rare.

What are the risks of surgery?

The risks of surgery are small and include the general surgical risks of any surgery. These include infection, ugly scar, skin numbness. More specific risks of this operation include fracture recurrent deformity and tendon damage. These risks will be discussed in detail with you before we proceed.

Patient Information Leaflets

Download Bunionette General Info

Download Bunionette Surgery

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Testimonials

I had a knee arthroscopy to removed and clean up damaged cartilage after 6 years of repeated injury and dislocation from playing sport. I had been putting off the idea of surgery, but it was a great decision to finally get it seen to. I couldn't be happier with the results so far, and in less time than expected. Running, squats and climbing stair caused pain, and a lot more cracking than a 22 year old's knee should have! Now 2 weeks after the op, and following the physio exercises given after the operations, I am driving and climbing/ descending stairs without a problem and on the road to a full recover and hoping to get back to regular exercise within the next few weeks.

I came to see you approximately four years ago and talked through the pros and cons of having an ACL replacement following an ACL rupture in my right knee I suffered playing an ill- advised game of beach volley ball on holiday in Antigua. I went ahead with the operation which you successfully performed at the Dunedin Hospital in Reading, I got on with my rehab and I now just wanted to let you to know that I will be running the London Marathon in three weeks (and raising money for Whizz-Kidz a disability charity for young people.) This letter is just a belated thank you for enabling this to happen.

Mr Davies is a fantastic surgeon he put in a half knee joint in my right knee I have no problem with it ever since the operation in August last year. I have no more pain in my knee at all. I would recommend him to anyone.

Mr Nev Davies has a very pleasant manner and was easy to talk to. The service provided was efficient, quickly identified the problems I had and was able to recommend treatment close to where I live.

Memberships

  • General Medical Council (GMC) Membership
  • Royal College of Surgeons of England (RCS(Eng.))
  • British Medical Association (BMA)
  • British Orthopaedic Association (BOA)
  • British Society of Children's Orthopaedic Surgery (BSCOS)
  • British Association of Surgery of the Knee (BASK)
  • AO European Trauma Group
  • British Orthopaedic Sports Trauma and Arthroscopy Association (BOSTAA)