Frequency and Characteristics of Extensor Hallucis
Capsularis: A Cadaveric Study
Atthakorn Jarusriwanna MD*,
Korakot Thamphongsri MD*, Bavornrit Chuckpaiwong MD*
Affiliation :
* Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Extensor hallucis capsularis is an accessory extensor tendon that is sporadically observed at the medial side
of the extensor hallucis longus tendon. Knowledge regarding frequency of occurrence and size of the tendon may help
surgeons decide whether to use this tendon or not when tendon graft is needed during foot surgery.
Objective : To evaluate the frequency, size, origin, and insertion of the extensor hallucis capsularis tendon in cadaveric
study subjects.
Material and Method: Extensor hallucis capsularis tendon was examined via dissection of 55 cadaveric feet. Thirty-six
male and 19 female cadavers were included, with an age range of 33 to 90 years (mean 67.3±14.0). One foot from each
study subject was dissected and evaluated (29 left feet and 26 right feet). Demographic data (gender, age, and height) and
outcome data (frequency, origin, insertion, length, and width of the tendon) were recorded. Tendon measurement reliability
was evaluated by intraclass correlation coefficient.
Results : Extensor hallucis capsularis tendon was found in 90.9% of cadaveric subjects. Mean tendon length and width was
11.3±4.0 cm and 1.6±0.6 mm, respectively. Most tendons branched from the extensor hallucis longus tendon and attached
to the first metatarsophalangeal joint capsule.
Conclusion : Extensor hallucis capsularis tendon was found in the vast majority of cadavers evaluated in this study. Most
originated from the extensor hallucis longus tendon and inserted into the first metatarsophalangeal joint capsule. Application
of this tendon as a tendon graft should be carefully considered due to variations of the length and the narrow width which
may limited strength of this tendon graft.
Keywords : Extensor hallucis capsularis, Extensor hallucis longus, Accessory tendon, Cadaveric study, Tendon graft
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