J Korean Foot Ankle Soc.  2014 Mar;18(1):19-23. 10.14193/jkfas.2014.18.1.19.

Treatment of Bunionette Deformity with Diaphyseal Oblique Osteotomy

  • 1Department of Orthopaedic Surgery, Seoul National University Boramae Medical Center, Seoul, Korea. kjh12344@hanmail.net


The purpose of this study is to evaluate the clinical and radiographic results of symptomatic bunionette treated with a diaphyseal oblique osteotomy.
We retrospectively reviewed 12 feet of nine patients diagnosed as symptomatic bunionette and treated with diaphyseal oblique osteotomy. All patients were female and the average age at the time of surgery was 48 years. We checked the foot standing anteroposterior, oblique, and lateral images pre- and post-operatively. We measured the fourth intermetatarsal angle and fifth metatarsophalangeal angle and evaluated the clinical results using the American Orthopaedic Foot and Ankle Society (AOFAS) lesser metatarsophalangeal-interphalangeal (MTP-IP) scale preoperatively and six months postoperatively.
Of the nine patients, hallux valgus was combined with symptomatic bunionette in seven feet of five patients. In all of our cases, the average AOFAS lesser MTP-IP scale showed improvement after surgery. Painful callosity around the fifth metatarsophalangeal joint disappeared after surgery in all of our cases. The fourth intermetatarsal angle improved from 12.7degrees to 3.1degrees and the fifth metatarsophalangeal angle improved from 16.6degrees to 2.3degrees.
Diaphyseal oblique osteotomy of the fifth metatarsal appears to be a safe and satisfactory surgical procedure for treatment of symptomatic bunionette.


Bunionette; Diaphyseal oblique osteotomy; Exostectomy; Fifth metatarsal

MeSH Terms

Bunion, Tailor's*
Congenital Abnormalities*
Hallux Valgus
Metatarsal Bones
Metatarsophalangeal Joint
Retrospective Studies


  • Figure 1. Surgical techniques of diaphyseal oblique osteotomy. (A) We performed a diaphyseal oblique osteotomy on the 5th metatarsal. The direction of the osteotomy was from the dorsal side of the proximal metatarsal to the plantar side of the distal metatarsal. (B) We corrected the location of the distal fragment under the C-arm fluoroscopy and inserted three 1.1 mm Kirschner wires (K-wires). (C) We removed one K-wire and inserted a 2.3 mm mini screw at the same position one by one. (D) Three mini screws were used for the fixation of the diaphyseal oblique osteotomy of the 5th metatarsal.

  • Figure 2. A 52-year-old woman with painful plantar callosity under the 5th metatarsal head on the right side. (A) Initial both foot standing antero-posterior images show increased 4th intermetatarsal angle (13.6o) and the 5th metatarsophalangeal angle (17.6o) on the right side. (B) The bunionette deformity was corrected with diaphyseal oblique osteotomy and fixed with three screws. (C) Bony union was achieved and the correction of the bunionette deformity was well maintained 6 months postoperatively.

  • Figure 3. The average and maximal and minimal values of the 4th IMA and the 5th MTP angles pre- and post-operatively. Preop: preoperative, Postop: postoperative, IMA: intermetatarsal angle, MTP: metatarsophalangeal.

Cited by  2 articles

The Impact of the Amount of Displacement of Percutaneous Osteotomy on the Clinical Result in Bunionette
Su-Young Bae, Seung-Joo Lee, Hyung-Jin Chung
J Korean Foot Ankle Soc. 2015;19(2):63-68.    doi: 10.14193/jkfas.2015.19.2.63.

The Effect of Weightbearing after Distal Reverse Oblique Osteotomy for Bunionette Deformity
Gab-Lae Kim, Yoonsuk Hyun, Jae-Hyuk Shin, Sangmin Choi, Kwon Kim, Junsik Park
J Korean Foot Ankle Soc. 2016;20(4):158-162.    doi: 10.14193/jkfas.2016.20.4.158.



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