Silicone implant arthroplasty of the great toe. A review of single stem and flexible hinge implants.

One hundred sixty-five feet were reconstructed with the single stem silicone implant, including patients with hallux regidus, hallux valgus due to degenerative and osteoarthritic joint changes, hallux valgus secondary to rheumatoid arthritis and patients with previous unsuccessful "bunion" procedures. Preoperative pain and intolerance to shoe wear were relieved in the great majority of patients. The amount of correction of the hallux valgus angle was directly related to the preoperative deformity. Infection occurred in 2 patients, and inflammatory reaction to the implant occurred in one patient. One hundred five feet were reconstructed with a flexible hinge implant; 94 of the feet had joints destroyed by rheumatoid arthritis. Dramatic improvement in the hallux valgus angle resulted in these feet which had relatively severe preoperative deformities. No implant fractures were recorded. The present survey of our cases, and experiences reported by others, encourage the use of these implants by surgeons who follow the suggested indications, surgical technique, and follow up care.