PURPOSE: The purpose of this study was to report impacts of the amount of displacement of percutaneous osteotomy on the clinical and radiologic results in the treatment of bunionette deformities. MATERIALS AND METHODS: We retrospectively reviewed 36 cases of bunionette deformities treated with percutaneous modified Kramer osteotomies from 2009 to 2013. We measured amounts of displacement on anteroposterior and lateral plain radiographs as well as multiple parameters which represent degrees of the bunionette deformities. We also recorded radiological healing time, clinical healing time, residual symptoms, and the time of returning to daily activity. RESULTS: No meaningful correlation was found between severity of preoperative deformity and amount of displacement of the osteotomy. The amount of displacement on a horizontal plane did not affect the healing time, duration of symptoms, or time of returning to daily activity. However, large sagittal displacement was related to duration of postoperative symptoms. CONCLUSION: Findings of this study suggest that the displacement in percutaneous osteotomy for bunionette deformity does not affect clinical results and healing time. We believe that we do not need to be excessively cautious about how large the displacement we make during the percutaneous modified Kramer osteotomy for the bunionette deformity.
Bunion, Tailor's* ; Congenital Abnormalities ; Osteotomy* ; Retrospective Studies

PURPOSE: The purpose of this study is to find out the normal angles of forefoot for diagnosis of bunionette deformity in Korea. This would be helpful as it would provide a basic angular measurement of bunionette deformity that indicates the need for operation. MATERIALS AND METHODS:Within a period of four months from January 2007 to April 2007. We have established 300 males and 600 feet without trauma history of foot. The source to image distance is 40 inches and erect weight bearing radiographs are obtained in anteroposterior and lateral projections. The significant angular measurements that define a bunionette deformity are the fourth-fifth intermetatarsal angle, the fifth metatarsophalangeal angle RESULTS:The mean age was 21 years(19-22 years) old. The mean 4th-5th intermetatarsal angle was 9.4+/-4.7 degrees , the mean 5th metatarsophalangeal angle was 7.9+/-9.2 degrees . CONCLUSION: We can consider over the 14.1 degrees on the 4th-5th intermetatarsal angle and over 17.1 degrees on the 5th metatarsophalangeal angle as an operational indication.
Bunion, Tailor's ; Congenital Abnormalities ; Foot ; Humans ; Korea ; Male ; Weight-Bearing

The bunionette, or a 'tailor's bunion', is a lateral bony prominence of the fifth metatarsal head. A bony deformity itself rarely causes symptom but if a painful inflammation of the overlying soft tissue is accompanied, it needs treatment. Conservative care using a shoe modification, padding, or orthosis is effective in most cases. Surgical management is indicated when the conservative methods have failed to improve symptoms, and the techniques include exostectomy, metatarsal osteotomies (distal, diaphyseal, or proximal), metatarsal head resection or fifth ray resection. We reviewed the etiology, clinical features, radiographic classification, nonoperative and operative treatments of the bunionette.
Bunion, Tailor's ; Congenital Abnormalities ; Head ; Inflammation ; Metatarsal Bones ; Orthotic Devices ; Osteotomy ; Shoes

PURPOSE: The authors intended to evaluate the results of symptomatic bunionette treated with a diaphyseal oblique osteotomy. MATERIALS AND METHODS: Nine patients were followed for more than 1 year after diaphyseal oblique osteotomy for a bunionette deformity with plantar callosity. The mean age was 43 years (23-69 years), and the mean follow-up period was 27 months (12-70 months). As a combined disorder, 7 patients had hallux valgus, for which 3 distal metatarsal oteotomies, 3 proximal osteotomies, and 1 double osteotomy were performed. Clinically, preoperative and postoperative AOFAS MP-IP scale, patient's satisfaction, postoperative complications were analyzed. Radiologically, the 4th intermetatarsal angle and the 5th metatarso-phalangeal angle were analyzed. RESULTS: Clinically, AOFAS MP-IP scale was increased from 59 points preoperatively to 93 points postoperatively, and all patients were satisfied with the results. The plantar callosity had all disappeared at the final follow up. The 4th intermetatarsal angle was decreased from 12.6degrees preoperatively to 4.3degrees postoperatively, and the 5th metatarso- phalangeal angle was decreased from 21.9degrees preoperatively to 2.4degrees postoperatively. There were no significant postoperative complications. CONCLUSION: Diaphyseal oblique osteotomy of the 5th metatarsal appears to be safe and satisfactory procedure for the treatment of a symptomatic bunionette with plantar callosity.
Bunion, Tailor's ; Callosities ; Congenital Abnormalities ; Follow-Up Studies ; Hallux Valgus ; Humans ; Metatarsal Bones ; Osteotomy ; Postoperative Complications

PURPOSE: To evaluate the radiological and clinical effects of early eightbearing after distal reverse oblique osteotomy of bunionette. MATERIALS AND METHODS: Between 2009 and 2015, 52 patients who underwent surgical treatment at our hospital for bunionette deformity with a minimum follow up of one year were included in the study. Postoperatively, foot cast was applied and full weightbearing was permitted in 28 patients. And short leg splint was applied with only partial weightbearing using crutches allowed in 24 patients. Clinical scores were evaluated. Radiologically, the 4th~5th intermetatarsal angle (IMA), and 5th metatarsophalangeal angle (MPA) were analyzed preoperatively and at the final follow up visit. RESULTS: The visual analogue scale and American Orthopaedic Foot and Ankle Society scores improved in the partial weightbearing group and full weightbearing group, but without significant differences. The average 4th~5th IMA and average 5th MPA correction also did not showed significant differences between the partial weightbearing group and full weightbearing group. Moreover, the full weightbearing group did not encourage non-union rate compared with the partial weightbearing group. CONCLUSION: Effective bone union may be achieved through early weightbearing, resulting in better clinical outcomes. It is considered that early weightbearing did not have any effect on the changes of IMA and bone union.
Ankle ; Bunion, Tailor's* ; Congenital Abnormalities* ; Crutches ; Follow-Up Studies ; Foot ; Humans ; Leg ; Osteotomy* ; Splints ; Weight-Bearing*

PURPOSE: This study was performed to evaluate the impact of the lesser toe operation on the overall clinical outcomes, and to analyze the clinical results of concomitant surgery for hallux valgus and lesser toe deformities. MATERIALS AND METHODS: Forty-six cases underwent surgery for hallux valgus with concomitant lesser toe deformities were followed up for at least 1 year. Lesser toe deformities consisted of 9 crossover toes, 10 claw toes, 12 hammer toes and 15 bunionettes. Clinical evaluation was performed according to AOFAS (American Orthopaedic Foot and Ankle Society) score, patient's satisfaction score, and pain VAS (visual analogue scale) score. Hallux valgus angle (HVA), intermetatarsal angle (IMA), and period to union were measured. Preoperative expectation about lesser toe deformities, postoperative satisfaction, complication rate, hospitalization period, medical expenses, and frequency of outpatient follow-up were analyzed. RESULTS: AOFAS score, VAS score, HAV and IMA had improved significantly. On preoperative expectation of patients, correction of lesser toe deformities was ranked third, following the improvement of big toe(bunion) pain and the correction of hallux valgus. Patient's satisfaction score was average 92.8 points, and the importance of lesser toe operation was 30.2%. When compared to hallux valgus operation only, there were average 2.5 days of additional hospitalization, 2.4 times of additional outpatient follow-up, 386000 won of additional medical expenses. CONCLUSION: Combined operation for hallux valgus and concomitant lesser toe deformities showed good clinical results. When compared to hallux valgus operation only, there were longer hospitalization, more frequent follow-up, more medical expenses, more complications. However, lesser toe deformity correction in patients underwent hallux valgus operation is considerable, because of high preoperative expectation and postoperative satisfaction.
Animals ; Ankle ; Bunion, Tailor's ; Congenital Abnormalities ; Follow-Up Studies ; Foot ; Hallux ; Hallux Valgus ; Hammer Toe Syndrome ; Hospitalization ; Humans ; Outpatients ; Toes

PURPOSE: The purpose of this study is to evaluate the clinical and radiographic results of symptomatic bunionette treated with a diaphyseal oblique osteotomy. MATERIALS AND METHODS: We retrospectively reviewed 12 feet of nine patients diagnosed as symptomatic bunionette and treated with diaphyseal oblique osteotomy. All patients were female and the average age at the time of surgery was 48 years. We checked the foot standing anteroposterior, oblique, and lateral images pre- and post-operatively. We measured the fourth intermetatarsal angle and fifth metatarsophalangeal angle and evaluated the clinical results using the American Orthopaedic Foot and Ankle Society (AOFAS) lesser metatarsophalangeal-interphalangeal (MTP-IP) scale preoperatively and six months postoperatively. RESULTS: Of the nine patients, hallux valgus was combined with symptomatic bunionette in seven feet of five patients. In all of our cases, the average AOFAS lesser MTP-IP scale showed improvement after surgery. Painful callosity around the fifth metatarsophalangeal joint disappeared after surgery in all of our cases. The fourth intermetatarsal angle improved from 12.7degrees to 3.1degrees and the fifth metatarsophalangeal angle improved from 16.6degrees to 2.3degrees. CONCLUSION: Diaphyseal oblique osteotomy of the fifth metatarsal appears to be a safe and satisfactory surgical procedure for treatment of symptomatic bunionette.
Ankle ; Bunion, Tailor's* ; Callosities ; Congenital Abnormalities* ; Female ; Foot ; Hallux Valgus ; Humans ; Metatarsal Bones ; Metatarsophalangeal Joint ; Osteotomy* ; Retrospective Studies

PURPOSE: The purpose of this study was to evaluate the clinical and radiological outcomes of the S.E.R.I. (simple, effective, rapid, inexpensive) operation for the bunionette deformity. MATERIALS AND METHODS: Between March 2005 and February 2009, 22 patients (26 feet) who had been treated for the bunionette deformity with minimally invasive osteotomy were reviewed retrospectively. Clinically, Visual Analogue Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score, shoes selectivity, disappearance of callus and patient's satisfaction level by Coughlin scoring system were evaluated. Radiologically, the bunionette was classified as four types according to the Fallat classification. The 4-5th intermetatarsal angle (4-5th IMA), the 5th metatarsophalangeal angle (5th MPA) and the length of 5th metatarsal bone (5th MTL) were analyzed at preoperatively and at final follow up visit. RESULTS: VAS improved from 6.8+/-1.8 points to 2.2+/-1.8 points (p<0.05). AOFAS score improved from 54.0+/-14.2 points to 90.0+/-4.8 points (p<0.05). There was no change in shoes selectivity. 9 feet (34.6%) were satisfied with excellent results, 16 feet (61.5%) with good results and 1 foot (3.9%) with fair results. The average 4-5th IMA was corrected from 10.1+/-2.3degrees to 4.4+/-1.7degrees (p<0.05). The average 5th MPA was corrected from 11.5+/-8.6degrees to -0.1+/-4.1degrees (p<0.05). The average 5th MTL was changed from 66.1+/-4.3 millimeters to 64.1+/-4.4 millimeters (p=0.069). There was no malunion, nonunion or delayed union and other perioperative complications. CONCLUSION: S.E.R.I. operation is less invasive and easy technique. This procedure is recommendable for the treatment of the bunionette deformity.
Animals ; Ankle ; Bony Callus ; Bunion, Tailor's ; Congenital Abnormalities ; Follow-Up Studies ; Foot ; Humans ; Metatarsal Bones ; Osteotomy ; Retrospective Studies ; Shoes

PURPOSE: The purpose of this study was to evaluate the clinical and radiological outcomes of the S.E.R.I. (simple, effective, rapid, inexpensive) operation for the bunionette deformity. MATERIALS AND METHODS: Between March 2005 and February 2009, 22 patients (26 feet) who had been treated for the bunionette deformity with minimally invasive osteotomy were reviewed retrospectively. Clinically, Visual Analogue Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score, shoes selectivity, disappearance of callus and patient's satisfaction level by Coughlin scoring system were evaluated. Radiologically, the bunionette was classified as four types according to the Fallat classification. The 4-5th intermetatarsal angle (4-5th IMA), the 5th metatarsophalangeal angle (5th MPA) and the length of 5th metatarsal bone (5th MTL) were analyzed at preoperatively and at final follow up visit. RESULTS: VAS improved from 6.8+/-1.8 points to 2.2+/-1.8 points (p<0.05). AOFAS score improved from 54.0+/-14.2 points to 90.0+/-4.8 points (p<0.05). There was no change in shoes selectivity. 9 feet (34.6%) were satisfied with excellent results, 16 feet (61.5%) with good results and 1 foot (3.9%) with fair results. The average 4-5th IMA was corrected from 10.1+/-2.3degrees to 4.4+/-1.7degrees (p<0.05). The average 5th MPA was corrected from 11.5+/-8.6degrees to -0.1+/-4.1degrees (p<0.05). The average 5th MTL was changed from 66.1+/-4.3 millimeters to 64.1+/-4.4 millimeters (p=0.069). There was no malunion, nonunion or delayed union and other perioperative complications. CONCLUSION: S.E.R.I. operation is less invasive and easy technique. This procedure is recommendable for the treatment of the bunionette deformity.
Animals ; Ankle ; Bony Callus ; Bunion, Tailor's ; Congenital Abnormalities ; Follow-Up Studies ; Foot ; Humans ; Metatarsal Bones ; Osteotomy ; Retrospective Studies ; Shoes

PURPOSE: To evaluate a symptomatic bunionette managed by a distal chevron osteotomy. MATERIALS AND METHODS: From 1997, among eighty-three patients who had been treated for a bunionette deformity with a distal chevron osteotomy, 17 patients, who had no other associated diseases, were reviewed retrospectively. The VAS pain score and AOFAS score, the patient satisfaction level, shoe selectability and disappearance of the callus on the foot were examined. The 5th metatarso-phalangeal angle and 4th and 5th intermetatarsal angle were measured using AP plain radiography. The bunionette was classified as types 1, 2, and 3 and the treatment results were analyzed. RESULTS: 8 male and 9 female patients were enrolled in this study. The mean age of the patients was 33.6 years (21-49 years). The mean follow-up period was 37.6 months (20-62 months). The pain VAS scores were 7.9 preoperatively and 1.2 postoperatively. The last follow-up AOFAS score was 94.7, and all patients were ranked at the very satisfied or satisfied level. All patients had also good shoe selectability and the callus on the lateral sole had disappeared. The preoperative 4th and 5th intermetatarsal angle (mean 10.2 degrees) and the 5th metatarso-phalangeal angle (mean 21.4 degrees) improved to 2.7 degrees and 7.2 degrees after surgery, respectively. There was a type 1, 2 and 3 deformity in 2 (12%), 1 (6%) and 14 patients (82%), respectively. The results among the types were satisfactory. CONCLUSION: A distal chevron osteotomy for the treatment of a symptomatic bunionette is safe, easy and can reduce the signs and symptoms. Regardless of the types of deformity, a distal chevron osteotomy can obtain satisfactory results.
Bony Callus ; Bunion, Tailor's* ; Congenital Abnormalities* ; Female ; Follow-Up Studies ; Foot ; Humans ; Male ; Osteotomy* ; Patient Satisfaction ; Radiography ; Retrospective Studies ; Shoes