Silastic arthroplasty of the first metatarsophalangeal joint should be considered a viable salvage procedure either for cases of previously failed fusion with interpositional tricortical bone grafting, or for cases of painful previous Kellers, as it can restore length back to the toe, power, stability of gait and therefore reduce pain.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3645788PMC
http://dx.doi.org/10.1136/bcr-2013-008993DOI Listing

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