First metatarsophalangeal joint arthrosis may be associated with hallux valgus deformity. In an attempt to address the pain and deformities of this disorder, silastic implant arthroplasty combined with soft tissue balancing and proximal first metatarsal osteotomy has been performed on 17 feet in 11 patients. A retrospective review of the results at an average followup of 29.5 months is presented. Subjective pain relief has been satisfactory, and loss of correction of deformity has been minimal. Infection remains as a significant postoperative complication. This technique may be a treatment option in the low demand patient with a hallux valgus deformity, painful arthritis of the first metatarsophalangeal joint, and a wide first intermetatarsal angle
Get full access to this article
View all access options for this article.
References
1.
. BeverlyM.C.HoranF.T.HuttonW.C.: Load cell analysis following silastic arthroplasty of the hallux. Int. Orthop. (SICOT), 9101, 1985.
2.
. BinghamR.: The stone operation for hallux valgus. Clin. Orthop., 17:366, 1960.
3.
. BrocaP.: Des difformites de la partie anterieure du pied produite par faction de la chaussure. Bull. Soc. Anta, 27: 60–67, 1852.
4.
. CluttonH.H.: The treatment of hallux valgus. St. Thomas Rep., 22:1, 1984.
5.
. CoughlinM.J.MannR.A.: Arthrodesis of the first metatarsophalangeal joint as salvage for the failed keller procedure. J. Bone Joint Surg., 69A:68, 1987.
6.
. CracchioloA.SwansonA.B.SwansonG.: The arthritic great toe metatarsophalangeal joint: a review of flexible silicone implant arthroplasty from two medical centers. Clin. Orthop., 157:64, 1981.
7.
. Davis-ColleyN.: Contraction of the metatarsophalangeal joint of the great toe (hallux flexus). Br. Med. J., 1:728, 1887.
8.
. Dow Corning Wright Co. (Monograph). Swanson flexible hinge toe implant and toe joint grommet. Form No. L083-0314, December, 1986.
9.
. FitzgeraldJ.A.W.: A review of long-term results of arthrodesis of the first metatarsophalangeal joint. J. Bone Joint Surg., 51B:488, 1969.
10.
. FitzgeraldJ.A.W.WilkinsonJ.M.: Arthrodesis of the metatarsophalangeal joint of the great toe. Clin. Orthop., 157:70, 1981.
11.
. HardyR.H.ClaphamJ.C.R.: Observations on hallux. J. Bone Joint Surg., 33B:376, 1951.
12.
. HarrisR.I.BeathT.: Army Foot Survey. Natl. Res. Council Canada, Ottowa, 1947.
13.
. HenryA.P.J.WaughW.: The use of footprints in assessing the results of operations for hallux valgus. A comparison of Keller's operation and arthrodesis. J. Bone Joint Surg., 57B:478, 1975.
14.
. HueterC.: Klinik der gelenkkrankheiten mit einschluss der or-thopaedie. Leipzig, F.C.W. Vogel, 1870–1871.
15.
. HuttonW.C.DhanendranM.: The mechanics of normal and hallux valgus feet—a quantitative study. Clin. Orthop., 157:7, 1981.
16.
. KellerW.L.: Further observations of the surgical treatment of hallux valgus and bunions. N.Y. Med. J., 95:686, 1912.
17.
. MannR.A.: Surgery of the foot. 5th Ed., C.V. Mosby Co., St. Louis, 1986.
18.
. MayoC.H.: The surgical treatment of bunion. Ann. Surg., 48:300, 1908.
19.
. McKeeverD.C.: Arthrodesis of the first metatarsophalangeal joint for hallux valgus, hallux rigidus, and metatarsus primus varus. J. Bone Joint Surg., 34:129, 1952.
20.
. MontagneJ.ChevrotA.GalmicheJ.M.: Atlas of Foot Radiology, Masson Publishing Co., 1981.
21.
. PeimerC.A.: Long term complications of trapezio metacarpal silicone arthroplasty. Clin. Orthop., 220:86, 1987.
22.
. SethuA.D'NettoD.C.RamakrishnaB.: Swanson's silastic implants in great toes. J. Bone Joint Surg., 62B(1): 83, 1980.
23.
. SilverD.: The operative treatment of hallux valgus. J. Bone Joint Surg., 5:225, 1923.
24.
. SwansonA.B.MaupinB.K.PetersJ.G.ShiS. M., The use of a grommet bone liner with the great toe flexible hinge implant. A.O.F.A.S. Inc. Meeting, St. Paul, MN, 1988.
25.
. SwansonA.B.: Implant arthroplasty for the great toe. Clin. Orthop., 85:75, 1972.
26.
. WengerR.J.J.WhalleyR.C.: Total replacement of the first metatarsophalangeal joint. J. Bone Joint Surg., 60B(1): 88, 1978.
27.
. WrightonJ.A.: A ten year review of Keller's operation. Review of Keller's operation at the Princess Elizabeth Orthopaedic Hospital. Exeter. Clin. Orthop., 89:207, 1972.
