Silastic implant arthroplasty with proximal metatarsal osteotomy for painful hallux valgus

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.