Multidirectional Y-V Flap Capsulorrhaphy in Hallux Valgus Surgery

Abstract

Although there are a number of techniques to address osseous deformity in hallux valgus surgery, the lateral soft tissue release and medial capsulorrhaphy are also important to a successful correction. Rebalancing the deforming forces is integral to a durable correction. We describe a new technique of multidirectional medial capsulorrhaphy that allows the surgeon to balance the soft tissue reliably in the coronal, sagittal, and axial planes. This described technique utilizes a Y-V flap configuration with multiple anchor points that can be tailored to the optimal tension and rotation to suit the individual deformity. Proper tensioning of the flap produces soft tissue balance and reduction of the sesamoids that is readily apparent with fluoroscopy. The technique is simple to perform and reproduce, and can be easily adopted and applied to any open hallux valgus procedure. Level of Evidence: Diagnostic Level V.