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The use of silicone elastomer implants in podiatric surgical practice is presently a well accepted treatment modality. However, there are instances of failure, and the present study describes a total collapse and fragmentation of a metatarsophalangeal joint prosthesis. Defects are demonstrated by scanning electron microscopy, while physical and chemical reasons for the occurrence as stated in the current literature are reviewed.

The two-stage capsular closure modification of the V-Y capsulorrhaphy in hallux abducto valgus surgery is a technique for restoring the soft tissue anatomical relationships of the first metatarsophalangeal joint in a bunion deformity. The first stage of the V-Y capsulorrhaphy corrects the plantar and lateral deviation of the abductor hallucis tendon. The second stage of the V-Y capsulorrhaphy closure allows for the correction of abductus and valgus rotation of the hallux. Inasmuch as each element of the soft tissue deformity in hallux abducto valgus deformity is corrected individually, greater precision can be applied to each constituent of the hallux abducto valgus deformity.