Bunionette Tailor's Bunion Surgery? [Corrector, Splints & Treatment]

This is Dr. Tom Biernacki I'm going over surgery for your fifth toe. Do you need the surgery? What's the recovery time? What's the secret? For your bunion. That pain, your outside of the foot. Pain in your fifth toe pain. We're starting now. The Tailor's bunion is like a bunion. So a bunion is essentially when your toe buckles out like that and it's bent. A bunion is different than arthritis. A bunion is basically a dislocating and bending bum that rubs. If this, for example, happens on the big toe, there's not necessarily arthritis. If it's arthritis and it can't bend up and down, that's something called Hallux Rigidus. You can get fifth toe arthritis as well. You can get swollen tissue along the fifth tone knuckle called bursitis swelling. You can get capsulitis. You can get a fist toe hammer toe where the toe essentially bends down like this or curls over the top. So you can get a lot of those types of things happening. They all have slightly different corrections. There are many types of Taylor's bunions. Number one, you could start with something called a bursa, which is not actually a problem with the bone, but it's a fluid sack. This is due to irritation swollen joint fluid occurs. number two, you could have a bump. You can see in the second example that fifth metatarsal head has a sharp, large bump. You could be born with this. This could be due to a prior broken toe. third type is an angle in the middle of the fifth metatarsal. could see it's not the angle between the fourth and the fifth metatarsal, but a deviation in the middle of the bone. Again, you could be born this way or it could be a break. And the last example is actual angle in between could be fairly large, and this could be due to the angle between the fourth and fifth metatarsal. I have a video that goes over the exact causes symptoms, diagnosis, X-rays on Tailor's bunions, including the top 15 ways to solve your Tailor's bunion without surgery. I link that below, but here we're going straight to the surgical therapies. Here's the causes and the risk factors of bone unit formation, genetics, a family history is more likely to cause it foot structure so people with wide four foot or long outwardly bent fifth metatarsals are more likely to get this. You can actually measure the angle of that bone on the x ray, and in some cases, if it's really deviated out, that might require surgery. Other people get it because of footwear. So especially women are more likely to get it tight, narrow, ill fitting shoes. Most of the patients that I see, the shoes are probably a little bit too small and they have hard stitched edges rather than soft mesh. Heavy mesh in the front of your shoe can make all the difference. It just prevents your toe from rubbing just as much. But a hard leather dress shoe can really cause some pain. Foot stress. So are you a runner? Are you a ballet dancer? And these can aggravate that. First, all the symptoms include a bony bump on the outside of the foot, pain and tenderness at the side of the bump swelling. It can feel like a fluid sac is built up there that can be called a bursa. You could have a corn, a callus, you could have pain underneath it, difficulty weighing certain types of shoes. Even with surgery, you want to consider the gel pads, good orthotics. So there's pre-made orthotics and there's custom 3D orthotics. The technology has gotten a lot better after surgery. Now I even recommend orthotics to patients where you can get a groove main out. You can get the right gel support, you can get the right shoe that's not rubbing on the side of your toe. And I also strongly recommend getting a biomechanical exam to check out your hips, your knees to make sure your foot is not rotating out because that's a huge contributor. This is what's important before you consider surgery, because even with surgery, if you have a ton of foot stress, if you're taking 30,000 or more steps per day, if you're wearing the wrong footwear, if you have certain foot structures like higher feet, if you have arthritic knees, hips, this could still cause you pain on the outside of your foot in your fifth toe. There's a lot of different tailors, bunion surgeries, essentially. These are a lot easier than a big toe joint bunion surgery If the conservative therapies are not effective and this is severe pain, you want to consider are a number one reshaping the bone. There is minimally invasive surgery now and you can essentially take a wand in the office and make a small poke and shave down the side of that bone. That's possible. So if there is a spur, if there's a jagged piece to that fifth tone knuckle, you could easily shave that down. You can modify the orthotic to take pressure off there. If there's an X-ray taken and it's just swollen. Occasionally an injection can make a lot of sense to try and cool that area down. If there's a spur or irritation that can happen, the next thing you want to do is soft tissue repair. So there's tendons and ligaments to balance that toe. You can take some stitching and you could release the tendons. On one side. You can do what's called the percutaneous Tanami. So if your toe is overlapping the fourth toe or underneath, you could do that in the office. Lengthen the tendons, the toes if it's a more severe deformity. So if your bone is really angled, there are small plates, small screws. So for example, if you break that fifth metatarsal, a plate and a screw can make a lot of sense. That can make a big difference for people. I recommend you go with a foot specialist and get that checked out. The results are generally pretty good. Statistically, long term, the success rates are well over 90% in a ten year study. What is the surgical process looks like? Well, you can go see your foot doctor and essentially get evaluated. How bad is the deformity? Do you need a bigger procedure? Do you need a smaller procedure? Did shoes and orthotics work for you? These are all things we consider in determining the procedure. Do you also need a big toe joint bunion? Do you need hammer toes corrected at the same time? A lot of the times it makes sense to do it all at once as you go in for surgery. Usually it's something lighter, like twilight sedation, so you're a little bit sleepy. The procedure is not extremely long and you usually go home the same day. Afterwards you wear a supportive shoe or a boot to keep pressure off that fifth toe knuckle. The recovery time generally varies. The smaller the surgery, you can immediately walk. If it's a bigger surgery, you might not be able to walk right away. I'd say for most fifth toe surgeries in most people, most people can walk right away and keep pressure off that fifth toe knuckle. The recovery time for Tailor's bunions surgery. Usually you can walk right away. A lot of times you'll have a surgical dressing on some stitches depending on if a bone cut was done. That's usually the major issue. If you had a lot of bone cuts, like, say, your big toe joint, bunion hammer toes, other stuff, you're probably going to have to keep pressure off of it for at least a week or two. If it's only the fifth toe, if it's more soft tissue, you can usually walk right away and you start to feel better after a few days. Now there's a difference between walking and your soreness going away. On average, if there's a bone cut, it takes six weeks to get to about 50%, takes three months to get to about 75%. It takes nine months to get to 90 plus percent. And one year where you're like, hey, there's absolutely no new symptoms. And this is kind of what it's going to look like. That being said, if it's soft tissue, you're going to heal a lot quicker. And we're talking you can start walking right away and the soreness will probably be gone over the next few months. That being said, too, you still want to wear good shoes, good orthotics, good gel padding. You want to do some physical therapy to work on your thighs, your hamstrings and hips, because there's probably a reason that this bone problem happened in the first place. So there are a lot of treatment options for a bone unit deformity. Most people think it's surgery, but it doesn't always have to be surgery. The most common thing that I see is getting the proper pair of shoes. Footwear modifications. Wearing shoes with a roomy toolbox can immediately take pressure off that bunion net. Get in the right shoes. I go over my favorite shoes for bunion deformities. I listen those below. But basically you want something nice, soft, supportive. I love shoes or better running shoes, for example, ortho feet shoes. If you're an older person for people that are older, have a lot of biomechanical deformities, check out my favorite shoe guides down below. I'll go over that with you. Another great option for Bunion and Deformities are padding. Another thing is toe separators. tOe pads, toe splints, cushioning the bunion. And the bunion at deformity with gel pads can be all you need. So, for example, if you're a lady who has to go to business meetings or you have a wedding or a nice dinner with your friends and you got to catch up and you need to wear those nice new shoes, that's one. A gel pad or a splint can make all the difference. Simply putting that on you don't have to switch your shoes. Just put that job head on while you're wearing them. Insoles that are orthotics are perhaps the number one solution for this problem. By holding your foot straight, it prevents that fifth toe from rubbing against the outside of your shoe. And let me show you that exact demonstration. So when I push down on the foot, see how it turns out that outside rubs against the side of the shoe right here. So I'm going to show you that again. When it pushes, your foot flattens out. That's called over pronation and your fifth toe right here rubs against the side of your shoe. Now, on the other hand, if I take my orthotic and I push on it, see how it's now no longer flattening out because the arch maintains as it presses the foot does not externally rotate. But for example, if I get rid of the orthotic, see how it now turns out. So the middle of the foot is called your Lisfranc joint right here. And if the foot cannot be held through the heel, it flattens out this way. And that fifth toe rubs against the side of the shoe. There's two types of orthotics. You can get premade ones and I list my favorites down below. But now there's great systems, too. You could have your podiatrist build an orthotic, which I love to do in person that does extremely well and the patient can get great results. But now technology has improved so much that you can essentially use your phone. You could consult with a specialist over your phone, talk about the knuckle right here. It stops and it takes pressure off that fifth toe joint. You can make a special groove in your custom orthotic. You can make it more built up. There is a lot of special modifications you can make in the prices on these things are coming down the list. My favorite ways to get your custom orthotic built down below that makes a huge difference. I highly recommend checking that out before you consider significant types of surgeries or more advanced treatments. This works the vast majority of the time for people. And that brings us to the big secret. There's always a biomechanics costs. Now for a rare set of people. The bone is actually curved or broken or deformed, but that's hardly any people. I'm talking less than 10%. The vast majority. They are going to have a tight back, a tight hip, a tight knee, and that causes your foot to turn out. That results in something called over pronation. You want to get some good proper shoes, some good orthotics, some 3D printed orthotics, or you want to get your muscle strength up your thighs, your hamstrings, your back. I have a great guide. It's a 30 day course to get your health, your muscle strength and your flexibility back online. And check that out below. Thanks for watching. Check out our full bunion at course, the top 15 remedies that don't involve surgery. That's length below as well.