Materials and methods
HV deformity
A prospective, randomized controlled trial of 78 patients who underwent operative treatment for mild to moderate HV from January 2018 to October 2021 was performed. The indications for surgery were that a symptomatic patient had conservative treatment that was ineffective. The inclusion criteria were as follows: ① age ranging from 18 to 70 years old and ② mild to moderate HV deformity (HVA of 20 to 40 degrees and IMA of 11 to 16 degrees [All patients were treated with lateral soft tissue release, chevron osteotomy, and medial capsulorrhaphy for HV, and the patients were separated into 2 groups according to the randomization approach. The randomization was achieved by using sealed envelopes. Each of the envelopes was prepared and contained one of the surgical techniques, and all 78 envelopes were stored in a box. These envelopes were drawn in the operating room before the surgery. All sealed envelopes were prepared by an independent person. A modified U-shaped capsulorrhaphy was implemented for the patients in group U, and an L-shaped capsulorrhaphy was performed for the patients in group L. All surgical procedures were performed by a single surgeon.The preoperative and follow-up data were collected for each patient, which included patient demographics (age, sex, general physical condition). Degrees of range of motion (ROM) of the first MTP joint, routine weight-bearing anteroposterior (AP), and lateral radiographs (including the HVA and IMA) were obtained preoperatively, as well as at 12 months after surgery. The HVA and IMA were measured by computer-assisted measurement. The ROM of the first MTP joint was obtained by using a goniometer and was taken while moving the first MTP joint from maximum plantar flexion to maximum dorsiflexion. Clinical results were assessed using the American Orthopedic Foot and Ankle Society (AOFAS) forefoot score before surgery and 12 months postoperatively.