A “tailor’s callous” can happen to anyone. It is referred to as the fifth toe of the foot or bunionette, a deformation of the metatarsal phalangeal joint along the outer edge of the foot with the appearance of a protuberance that makes it painful to wear different types of footwear. It is known as the tailor’s callus because it is associated with the callus that occurs on the feet of those who sewed for too long with their legs crossed on the ground. It is a twin condition of the valgus toe and it is precisely with this very common condition that the fifth toe shares several elements, as Dr. Leonardo Maradei, Head of Foot and Minimally Invasive Surgery at Humanitas, recalls.
A protrusion and a callus on the little finger
The fifth finger launch is more frequent among women, just like the valgus toe, and it can arise at any age. In addition to the bone protuberance, which can evolve over time and become increasingly marked, swelling and redness can also appear on the skin surface. The callus itself can also appear, with the skin at the base of the little finger becoming thicker.
But why does this protrusion form? “Its onset – explains Dr. Maradei – is favored by the conformation of the foot. The use of some footwear such as heeled shoes and especially narrow pointed shoes can favor it but are not the cause of this condition. In individuals with family history, using footwear that is too tight at the toe or even on the sole with incorrect foot support may result in an early manifestation of the fifth launch toe. Wearing the wrong shoes becomes a problem, however, when this condition has already developed.
A doctor can make a diagnosis with a physical examination, but he can also use an x-ray of the foot to accurately define the contours of this disorder: “You can also realize the possible presence of a valgus toe and bunionette, with the first and fifth toe beginning to “face each other”.
Forward heeled shoes
The pain the subject feels derives from the foot conflict against the shoe so you can initially try to wear suitable footwear that leave more space for the fifth toe, with a soft foot bed that avoids overloading the metatarsus phalangeal joint: “This is the measure provided for the conservative treatment of the bunionette. If the resolution is not achieved, surgery will be performed,” remembers the specialist.
The operation is performed under Day Hospital and under loco-regional anesthesia: “The objective of surgery is to resolve the deformity. As with the valgus toe, an osteotomy of the fifth metatarsus is performed using a minimally invasive procedure, as effective as classical surgery. The protruding part of the bone is moved, and the deformity is corrected by means of special instruments inserted through small skin holes.
The post-operative period is important: “For several days the patient will have to walk with supportive shoes, in which the heel is not positioned on the heel but on the toe to avoid loading the front part of the foot that has undergone the operation”, concludes Dr. Maradei.