The first MTP joint capsule provides complete joint containment and is divided and repaired strategically in hallux valgus correction. The lateral capsule release and medial capsule-periosteum imbrication are key steps in the Chevron, Scarf, and Lapidus osteotomy procedures for hallux valgus correction. The plantar plate and sesamoid complex are integral components of the capsular complex.
| Location | Around the first metatarsophalangeal joint at the base of the big toe |
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Encloses the first metatarsophalangeal joint, holds the sesamoid complex beneath the metatarsal head through its thickened plantar part (plantar plate) and collateral ligaments, and becomes stretched medially and contracted laterally as hallux valgus develops.
Hallux valgus correction requires careful lateral capsular release (to allow medial correction of the metatarsal head) combined with medial capsular advancement (to provide medial soft tissue tension and help hold the sesamoids under the metatarsal head). Overcorrection producing hallux varus from excessive lateral release or overtight medial imbrication is a recognised complication requiring corrective procedures. In turf toe, the plantar capsule and plantar plate tear in forced hyperextension.
First MTP capsule lateral release and medial imbrication combined with metatarsal osteotomy corrects hallux valgus deformity.
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