Bunionette / Tailor's Bunion Surgery in Vienna
the pressure point on the little toe – gently corrected

A bunionette – also called a tailor's bunion – is a bony prominence on the outer edge of the foot at the base of the little toe. It is essentially the mirror image of a hallux valgus: the fifth metatarsal splays outward while the little toe drifts inward. The prominence rubs against the shoe, which leads to redness, an inflamed bursa, pressure points and pain, especially in narrow footwear.

No. In the early stages roomier shoes, soft padding, insoles and treating the irritated bursa are often enough to keep the symptoms in check. Surgery becomes worthwhile when the pain persists, when the bursa keeps flaring up, or when the choice of shoes is clearly limited. Because a bunionette is a bony deformity, only surgery can correct the underlying cause permanently.

The prominence is corrected at its root by a small osteotomy of the fifth metatarsal: the bone is cut in a controlled way, moved inward so the forefoot becomes narrower, and fixed in the new position with a small titanium screw. This removes the pressure point permanently instead of just shaving off the bump. The procedure takes around 30–45 minutes and is usually performed on an outpatient basis under regional anaesthesia.

For a desk job you are usually back after about 2–3 weeks, provided you can elevate the foot regularly. For work that involves a lot of standing or walking, plan for around 4–6 weeks, because the osteotomy of the fifth metatarsal needs that time to heal. You wear a flat surgical shoe and bear weight on the heel from the start – no cast and no crutches are required.

With supplementary (Sonderklasse) insurance the operation and hospital stay are generally covered in full and billed directly with your insurer. Without supplementary insurance the procedure is possible as a self-payer at any time – you receive a transparent, written cost estimate in advance, with no hidden extras. The exact amount depends on the technique and whether other forefoot corrections are performed at the same time, so I put it in writing before anything is decided. For practice visits, statutory insurers reimburse roughly 80% of their tariff afterwards.

A bunionette belongs in the hands of an orthopaedic foot specialist. Dr. Philippe Ghobrial performs the correction himself and assembles the team that looks after you before, during and after the operation. He works exclusively as a private physician (Wahlarzt) but treats all patients – privately insured, Sonderklasse-insured and self-payers. As a Wahlarzt patient you can have part of the practice costs reimbursed by your statutory insurer afterwards.