Bunionette

A bunionette is similar to a bunion as a painful bone prominence of a metatarsal head and overlying bursa, but it involves the fifth metatarsal.

  • The fifth metatarsal deviates laterally and the fifth toe medially
  • It has also been called a tailor’s bunion
  • high association with constrictive shoes
  • Much more common in women than in men

Surgical Procedures:

Chevron Osteotomy:

An open procedure for smaller deformities requiring a distal metatarsal osteotomy but no fixation

Ludloff Osteotomy:

An open procedure for larger deformities involving osteotomy of the proximal metatarsal and includes implanted hardware for fixation

Bunionette Forefoot Surgery
Post Operative Instructions

Cast:

  • You will have a dressing on your foot for 2 weeks following surgery
  • A post op shoe will be worn for 6 weeks post op
  • Any exposed wires are covered by CLEAR tape
  • At 6 weeks, you will wean off the shoe and begin walking in a regular shoe

Wound:

  • The surgical incision has been closed with sutures
  • Do not get the dressing or wound wet for the first two weeks.
  • When showering place a bag over the dressing and secure with tape to your leg to avoid the cast and wound getting wet
  • Stitches will be removed at your 2 week appointment
  • After the stitches are removed, you may begin to shower after 2-3 days
  • Do not immerse the foot in water (bath, hot tub, pool) for 6 weeks
  • Do not apply any lotions or creams on the wound for 6 weeks

Weight Bearing:

  • You will be weight bearing as tolerated for the first 6 weeks while in a post op shoe.
  • You will use a mobility device to offload your foot (crutches, walker, stirrup cast)

Medications:

  • Pain medication should be used regularly for the first 24-48 hours, when required for the first 1 to 2 weeks, followed by Regular Tylenol

Driving:

  • For right foot surgery you are not permitted to drive until you have completely weaned off the past op shoe
  • For left foot surgery, please contact your insurance company to see if you are permitted to drive
  • Driving is not permitted while on narcotics

Work:

  • Two weeks off work is recommended for initial recovery
  • If you are able to get to work safely, and will be seated for the majority of the day, you may return to work a couple days after surgery. This is assuming you are not taking narcotic pain mediation.
  • From 2-6weeks sedentary duties is recommended
  • By 6 weeks you can gradually return to full duties
  • If your job is physically demanding, return to full duties is usually possible around 8-12 weeks post operatively

Follow Up:

  • You will have your first appointment 2 weeks after surgery in the Fracture Clinic
  • Your next appointments will be at 6 weeks, 3 months then 6 months post operatively
  • You will have x-rays taken at these appointments

Recovery:

  • It is normal to experience mild to moderate pain, numbness, or tingling for the first 2 weeks following surgery
  • Please come to the emergency department if you are suffering from severe pain
  • You will get back to most of your activities by 6-12 months
  • Swelling often remains for 6-12 months
  • Residual stiffness is a normal consequence of ankle fracture

Physiotherapy: