Safe and Effective:
When performed correctly the procedure described in conjunction with the SHIP Implant, yields impressive results.

Simple and Quick Procedure:
Tools needed: burr with btop, broach, burr without stop, color coded sizers.

Step One:
Semi-elliptical incisions are made on the second, third, and fourth toes. A straight incision is used on the fifth toe.

Step Two:
The extensor longus tendon is transversely incised proximal to the interphalangeal joint and reflected distally.

Step Three:
An arthroplasty is performed excising 6-8 mm of the proximal phalanx head.

Step Four:
Excise all sharp edges from the phalanx stump. Drill the canals for the stems using the SHIP burr with stop for the small and medium SHIP implant.  The broach is used to enlarge and square the pilot hole.

Sizer Use:
A color coded sizer is used to determine the final fit of each implant. The stems should fit so that the implant abuts flush against the intermediate phalanx and the proximal phalanx stump. After sizing of the implant the wound is flushed copiously. An antibiotic flush is recommended.

Step Five:
The closing steps are: 1) suture the tendon, 2) close the subcutaneous tissue, 3) close the skin. This closes the pocket around the implant securely, stabilizing the toe. The correction should be achieved at this time. A Betadine soaked sponge is an excellent splint for the first two weeks. Wrap each toe individually with 1 inch Coban starting at two weeks post-op. Use prophylactic antibiotics on every toe implant case.

On certain fifth toes there is a need for an additional osteotomy of the lateral one-fourth of the intermediate phalanx.  This will aid in narrowing the girth of the toe.  This is usually performed prior to the arthroplasty of the proximal phalanx head.  the arthroplasty is then performed and the implant can be put in place.  There is ample intermediate phalanx base left to drill a hole for the distal stem.