The treatment of rigid hallux using Swanson’s silastic implant (single and double stem). Clinical, radiological and podobarographic review with a 16-year maximum follow-up.

Mahieu C, Chaput A, Bouillet R. Acta Orthop Belg 1992;58(3):314-24.

Twenty-eight cases of hallux rigidus treated with the Swanson Silastic implant (single and double stem) were reviewed, with an 8-year follow-up. The skin complication rate was significant. Long-term patient satisfaction was good. Radiologic findings were alarming: implants seem to wear out quickly on the articular side, and granulomatous reactions develop around the stems. Dynamic pedobarography shows decreased pressure under the first ray, with transfer of the weight to the midmetatarsal heads, sometimes on the external edge of the foot. The authors review the international literature on the etiology, pathology and treatment of hallux rigidus. Surgical indications and techniques are specified.