ExoToe LLC was born out of Surgical Design Innovations in 2016. ExoToe represents the first hammertoe implant that is extramedullary as it wraps around the phalanges for digital fusion of hammertoe deformities. ExoToe is simple to place, requiring only a sizer and crimping tool. While the 1 million hammertoe procedures done annually have garnered significant attention from industry, all of the efforts have been made with intra-medullary devices (inside the bone). Foot and ankle surgeons have been slow to adopt and stay with IM devices due to the cumbersome technique, instrumentation, mechanical failures, cost, and inability to adequately control the MPJ. ExoToe offers solutions around all of these shortcomings. With nearly 1800 implanted devices, ExoToe boasts a 94% union rate (highest reported union rate in the literature), less than 1% explantation rate, no mechanical failures, and high surgeon acceptance.