A bunionette is a painful prominence on the lateral aspect of the head of the fifth metatarsal bone. The deformity is common in adolescents and adults, mostly females and athletes. Like bunions, most bunionettes are caused by frequent wearing of ill-fitting shoes that constrict the forefoot. Additionally, several anatomic variations of the fifth metatarsal have been documented and may lead to bunionette deformity. Nonsurgical treatment for bunionette includes local padding of the prominence, wearing shoes with a wider toe box area, and anti-inflammatory medications. Surgery is indicated for bunionette if conservative care fails to relieve symptoms. Surgical treatment should be determined by the type and location of each bunionette deformity. Surgical options include lateral resection or shaving, distal chevron osteotomy, and diaphyseal oblique osteotomy.
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