synonyms: nutcracker fracture
Cuboid Fracture ICD-9
Cuboid Fracture Etiology / Epidemiology / Natural History
- Fractures occur with the forefoot everted on hindfoot pinching cuboid between anterior calcaneus and bases of 4th and 5th metatarsals.
- Untreated displaced / compression fractures can lead to relative shortening of the lateral column, planus and abduction deformities of the midfoot and chronic pain.
Cuboid Fracture Anatomy
- Tranvsere Tarsal joint (Chopart's Joint) = Cuboid articulations with the calcaneous proximally and the talus and navicular medially.
Cuboid Fracture Clinical Evaluation
- foot pain, unable to bear weight
- tenderness and swelling over lateral midfoot
Cuboid Fracture Xray / Diagnositc Tests
- Xray: A/P, Oblique, Lateral foot views. A/P, lateral foot often appear normal. Best seen on oblique view.
- CT: may be useful for fractures poorly seen on plain films.
Cuboid Fracture Classification / Treatment
- Avulsions: common due to numerus capsular and ligamentous attachments to the cuboid.
-Treatment: 5-7 days NWB, elevation followed by progressive weight bearing and functional rehab.
- Displaced / Compression fractrues =open reduction and internal fixation and possible bone grafting is necessary to prevent the development of late painful arthritis (Sangeorxan BJ, JBJS 1990;72Br:376).
Cuboid Fracture Associated Injuries / Differential Diagnosis
Cuboid Fracture Complications
- Postraumatic Arthritis
Cuboid Fracture Follow-up Care
- NWB for 3 months
- Semirigid custom-molded arthosis
Cuboid Fracture Review References
- Hunter JC, Sangeorzan BJ: A nutcracker fracture: Cuboid fracture with an associated avulsion fracture of the tarsal navicular. Am J Roentgenol 1996;166:888.
- Sangeorzan BJ, Swiontkowski MF: Displaced fractures of the cuboid. J Bone Joint Surg 1990;72B:376-378.