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An Overlooked Deformity in Patients with Hallux Valgus

Tailor's Bunion

Alper Deveci Department of Orthopaedics and Traumatology, Ankara Numune Education and Research Hospital, Ankara, Turkey.

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Serdar Yilmaz Department of Orthopaedics and Traumatology, Ankara Numune Education and Research Hospital, Ankara, Turkey.

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Ahmet Firat Department of Orthopaedics and Traumatology, Ataturk Education and Research Hospital, Ankara, Turkey.

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Ahmet Ozgur Yildirim Department of Orthopaedics and Traumatology, Ankara Numune Education and Research Hospital, Ankara, Turkey.

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Ozdamar Fuat Oken Department of Orthopaedics and Traumatology, Ankara Numune Education and Research Hospital, Ankara, Turkey.

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Murat Gulcek Department of Orthopaedics and Traumatology, Ankara Numune Education and Research Hospital, Ankara, Turkey.

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Ahmet Ucaner Department of Orthopaedics and Traumatology, Ankara Numune Education and Research Hospital, Ankara, Turkey.

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Background

Tailor's bunion is a deformity of the fifth toe, and its concomitance with hallux valgus (HV) is defined as splayfoot deformity. Treatment is focused on the HV deformity in splayfoot, and the tailor's bunion deformity can be overlooked. The frequency of HV concomitant with tailor's bunion in splayfoot has not been reported in the literature.

Methods

A retrospective evaluation was performed to detect the existence of tailor's bunion deformity in 203 patients (376 feet) treated for HV. Standing anteroposterior and lateral radiographs were used in the radiologic evaluation. Fallat's classification was used to grade tailor's bunion. Surgery for HV was applied to 86 patients (136 feet), and conservative treatment was applied to 117 patients (240 feet). Mean follow-up was 28.3 months (range, 18–42 months). Clinical evaluation was by American Orthopaedic Foot and Ankle Society (AOFAS) score.

Results

Of the 376 feet with HV, 28 (7.4%) had tailor's bunion, of which 17 (60.7%) were overlooked according to the surgery criteria for tailor's bunion. In the HV surgery group, there were no differences in preoperative mean AOFAS scores according to concurrence with tailor's bunion, but postoperative AOFAS scores were low in patients with accompanying tailor's bunion (P < .001). In the conservative group, no differences were determined in mean AOFAS scores according to tailor's bunion.

Conclusions

Tailor's bunion deformity sometimes goes undiagnosed in patients with treated HV. This deformity must be kept in mind for patients with HV to improve clinical results.

Corresponding author: Alper Deveci, MD, Ankara Numune Education and Research Hospital, Talatpasa, Ankara, 06100, Turkey. (E-mail: alper_deveci@yahoo.com)