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An Overlooked Deformity in Patients with Hallux Valgus

by MASS4D® Prescription Orthotics January 11, 2017


Tailor’s bunion or bunionette is defined as a lateral prominence of the fifth metatarsal head; its concomitance with hallux valgus (HV) is defined as splayfoot deformity.

In literature, there is no mention of a treatment algorithm for patients with both tailor’s bunion and HV.

This study aimed to evaluate the frequency of tailor’s bunion in patients with HV deformity and the effects on the clinical results of HV treatment, according to whether it was accompanied by tailor’s bunion.

A retrospective evaluation was undertaken of the data from 203 patients diagnosed as having HV treated surgically or conservatively, to detect the existence of tailor’s bunion deformity.

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Standing anteroposterior and lateral radiographs were used for radiologic evaluation.

Grading of the tailor’s bunion was made using Fallat’s classification: enlargement of the fifth metatarsal head (type 1), lateral bowing of the metatarsal head without enlargement (type 2), and increased fourth and fifth intermetatarsal angles (type 3).

For HV surgery, a chevron or scarf osteotomy was applied, and for tailor’s bunion surgery, a diaphyseal oblique osteotomy.

In the conservative group, treatment was applied with various orthoses, such as toe separators, metatarsal pads, and night splints.

American Orthopaedic Foot and Ankle Society (AOFAS) scoring was used for functional evaluation; these scores were evaluated preoperatively, at the final follow-up in the surgical group, and at the first admission in the conservative group.

In the present study, no significant difference was found in the preoperative AOFAS scores of the HV surgery group and the conservatively treated HV group, including those with and without tailor’s bunion.

The AOFAS score in the group that underwent surgery for HV but did not have surgery for the accompanying tailor’s bunion, was significantly lower than that in the group that did not include tailor’s bunion that underwent HV surgery.

The results of the present study show that tailor’s bunion accompanying HV deformity affects the clinical results after HV surgery, to a statistically significant degree and should not go overlooked.

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  1. Alper Deveci, Serdar Yilmaz, Ahmet Firat, Ahmet Ozgur Yildirim, Ozdamar Fuat Oken, Murat Gulcek, Ahmet Ucaner (2015) An Overlooked Deformity in Patients with Hallux Valgus. Journal of the American Podiatric Medical Association: May/June 2015, Vol. 105, No. 3, pp. 233-237

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