Forty cases of hallux rigidus treated by Silastic hemiarthroplasty over an average period of 110 months have been reviewed here. As many as 36% (14 feet) of the patients were unhappy with the results of their operation. Six implants had to be removed because of increasing pain and fragmentation of the prosthesis. These patients improved after the prosthesis was removed. It is concluded that Silastic hemiarthroplasty does not give an acceptable level of good results when compared with published reports of other forms of treatment. The probable causes of the high dissatisfaction rate are discussed.
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