The Bunionette Deformity: Overview and Classification

Patients with bunionette deformity may present with symptoms of lateral forefoot pain. Multiple anatomic factors may play a role in the deformity and symptoms, and the clinical examination should focus on the underlying pathology present to guide appropriate treatment. Attempts have been made to distinguish normal anatomy from pathologic deformity, based primarily on radiographic measurements. A classification system has been developed to guide the surgeon in diagnosis and treatment: type 1 results from a large fifth metatarsal head; type 2 results from excessive lateral bowing of the fifth metatarsal; type 3 is the result of an increase in the 4-5 intermetatarsal angle. All patients with bunionette deformity should be treated initially with a trial of nonoperative management focusing on diminishing symptoms.