Understanding Lesser Metatarsal Osteotomy: A Guide to Tailor’s Bunion Surgery
- Coriel
- Apr 23
- 3 min read
If you’ve been struggling with pain, deformity, or a prominent bone on the outer side of your foot due to a tailor’s bunion, you might be considering lesser metatarsal osteotomy. This surgical procedure is effective in reducing discomfort and restoring foot function. Here’s everything you need to know about the surgery and what to expect.
What is Lesser Metatarsal Osteotomy?
Lesser metatarsal osteotomy is a procedure designed to correct tailor’s bunion deformity. This condition, also known as a bunionette, occurs when the fifth metatarsal bone protrudes outward, causing pain, deformity, or issues with footwear.
During the surgery, a small incision is made on the side of the affected joint. The surgeon cuts and realigns the fifth metatarsal bone, securing it with a wire or screw to maintain its corrected position. This procedure typically lasts 30 to 45 minutes and effectively reduces the prominence and associated pain.
Why Consider This Surgery?
The main goals of lesser metatarsal osteotomy are:
To alleviate pain and deformity caused by the protruding bone.
To reduce callous or corn formation.
To improve overall foot comfort and functionality.
This procedure has proven effective, with studies showing high levels of patient satisfaction two years post-surgery.
Risks and Considerations
As with any surgical procedure, there are specific risks associated with lesser metatarsal osteotomy, including:
Joint stiffness (5%).
A floating toe that doesn’t touch the ground (5%).
Non-union of the bone (failure to heal correctly).
Fixation problems with screws or pins.
Mild occasional joint pain (15%).
These risks are relatively uncommon, and your surgical team will discuss ways to minimize potential complications.
Who is a Candidate for This Procedure?
This surgery is typically recommended for individuals with:
Pain or bursitis from a prominent fifth metatarsal joint.
Difficulty finding comfortable footwear despite wearing sensible options.
Associated deformities, such as an under-riding fifth toe.
If these symptoms are affecting your quality of life, lesser metatarsal osteotomy might be the right solution for you.
Alternative Treatments
Before considering surgery, your healthcare provider may suggest:
Altering activity levels.
Using painkillers or anti-inflammatory medications.
Trying custom footwear or orthotic foot supports.
Exploring joint injection therapy.
It’s important to note that while these methods can manage symptoms, they may not correct the deformity.
What to Expect During Surgery
The procedure is typically performed under a local anaesthetic block, which involves injections around the ankle or behind the knee. You’ll remain awake but pain-free, feeling only touch or pressure. For patients uncomfortable with being awake, sedation or general anaesthesia options can be explored with your consultant.
Lesser metatarsal osteotomy is a day surgery, so you can return home the same day. Ensure a responsible adult is available to assist you during the first 24 hours.
Recovery Timeline
First 2-4 Days:
Pain management will be provided with appropriate medication.
Rest is crucial. Keep your foot elevated and limit movement to essential activities using crutches.
One Week After Surgery:
Your foot may be checked and re-dressed during a follow-up appointment.
Gradually increase activity within pain limits.
Two Weeks After Surgery:
Sutures, if any, will be removed.
You can transition to wearing trainer-type shoes and no longer need bandages or crutches.
2-6 Weeks After Surgery:
Your foot will begin to return to normal, though swelling may persist.
Regular shoes can typically be worn after 6-8 weeks.
You may return to work, though active jobs may require additional recovery time.
You can resume driving once you can perform an emergency stop safely and have cleared it with your insurance company.
8-12 Weeks After Surgery:
The foot should feel more functional, with less swelling.
Sporting activities can be considered after three months, depending on your recovery progress.
Six Months After Surgery:
A follow-up review will assess your progress.
Swelling should be minimal, and you’ll likely experience the full benefits of the surgery.
Twelve Months After Surgery:
Full healing will be complete, and improvements will have stabilised.
Planning for Recovery
To ensure a smooth recovery, it’s essential to prepare in advance:
Arrange for a support system to assist with daily activities during the early recovery phase.
Use crutches or mobility aids as recommended by your medical team.
Follow all post-operative care instructions closely.
Lesser metatarsal osteotomy is a reliable solution for those dealing with tailor’s bunion deformity and associated discomfort. By addressing the underlying issues, this procedure can significantly enhance your quality of life. If you’re considering surgery, consult your healthcare provider to determine if this treatment is the right fit for your needs.
