Range of Motion of the First Metatarsophalangeal Joint After Different Capsulorrhaphies: A Comparative Cadaver Study.

BACKGROUND: Capsulorrhaphy restricts the motion of the first metatarsophalangeal joint (MTPJ) in hallux valgus surgery. However, changes in motion of the first MTPJ immediately after surgery that resulted from different capsulorrhaphy methods have not been compared. The primary aim of this study was to compare the immediate effect of Y-shaped and inverted L capsulorrhaphy methods on the range of motion (ROM) of the first MTPJ.

METHODS: Y-shaped and inverted L capsulorrhaphies were performed on 16 human cadaveric feet. Passive dorsiflexion and plantarflexion of the first MTPJ were then compared preoperatively and postoperatively.

RESULTS: In this cadaveric study, the inverted L capsulorrhaphy method led to a ROM loss in the first MTPJ; the joint stiffness from the Y-shaped capsulorrhaphy is significantly less than that from the inverted L capsulorrhaphy.

CONCLUSIONS: The inverted L capsulorrhaphy may lead to a ROM loss in the first MTPJ immediately after surgery. We recommend that surgeons close the capsule of the first MTPJ with a Y-shaped capsulorrhaphy, which is less likely to result in a ROM loss in the first MTPJ in the early postoperative period.