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Letters to the Editor

the dorsal aspect of the distal stem of the prosthesis and once a stress concentration has been produced (a small abrasion) fatigue failure rapidly follows at the junction of the distal stem and hinge of Swanson prosthesis. This accords with clinical findings. While there will always be differences between individual patients which may lead to different magnitudes and directions of loading in specific cases, it seems that the models offered by Williams et al. need some refinement to match ex vivo fractures of Swanson and Sutter metacarpophalangeal prostheses more closely.