Bhagath Kumar Potu & Amer Almarabheh

The main goal of our study was to analyze the morphometrics of the extensor hallucis capsularis (EHC), an accessory tendon arising from the extensor hallucis longus (EHL). Despite its functional importance, there is no comprehensive data available on the prevalence, origin, insertion, and morphometrics of the EHC. Therefore, we systematically reviewed the EHC with more emphasis on its length and width. A systematic literature search using PRISMA guidelines was performed in databases such as MEDLINE, Google Scholar, SciELO, and Cochrane reviews using search terms such as “Extensor Hallucis Capsularis”, AND “prevalence OR origin OR insertion OR length OR width”, which yielded 315 article links. Of the nine articles that met the inclusion criteria, only six cadaveric studies comprising 260 EHC tendons from 338 lower limbs had the morphometric data. The specimens included in these six studies are in a range of 21- 82.2 years age. Pooled data (Mean±SD) of the EHC showed: total length 8.30 ±3.01cm, and width 2.26 ± 1.19mm, respectively. Our pooled analysis revealed that the EHC most commonly originated from the EHL tendon (97.6 %) followed by the tibialis anterior (2.3 %) and mainly inserted on the first metatarsophalangeal joint capsule (75.3 %), followed by the base of the proximal phalanx (23.4 %) and head of the metatarsal bone (1.3 %). Our data generated more representative values on the morphology of EHC from the available literature and this information would be of great advantage for surgeons to compare its surgical adequacy while using it as a tendinous graft in various surgeries.

KEY WORDS: Extensor hallucis capsularis; Morphometrics; Graft; Surgical; Adequacy.

POTU, B. K. & ALMARABHEH, A. Extensor hallucis capsularis tendon morphometrics and its role as a potential graft: A systematic review. Int. J. Morphol., 43(4):1370-1375, 2025.