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Indiana Podiatry Group
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Avoid Permanent Damage After a Cuboid or Cuneiform Fracture in Indiana

The cuboid is a roughly cube-shaped bone found on the outer side of the foot just past the end of the heel bone, and just before the bone prominence that flares out in the mid-part of the outer edge of the foot. It is thick, strong, and fractures involving only this bone are rare. However, the cuboid does become fractured in combination with injuries that cause fractures to other bones adjacent to it.

Several fracture patterns can be seen when the cuboid does fracture. This can include a shearing of bone off the surface of the cuboid, a fracture of the main body of the bone that can be in one piece, several pieces, or outright crushed, and a fracture that is fully dislocated out of position.

The typical cause of a cuboid fracture, as well as fractures associated with it, is a rotational injury of the foot where the foot abnormally rotates and flexes, causing a nutcracker-like crush to the cuboid. Objects directly dropped on the bone or struck against the side of the foot can also cause fracturing.

Treatment typically involves immobilization in a cast or fracture boot for 6-8 weeks. If the bone has displaced, it will need to be pushed back into place and then the foot can be immobilized. Sheared fracture fragments that still cause pain after healing may need to be surgically removed, and crushed type fractures may require a fusion of the heel bone and the cuboid to eliminate arthritic pain resulting from the bone loss.

The cuneiforms are a group of three bones that comprise the 'keystone' portion of the top of the arch across the foot. They are located next to the cuboid bone, and can become fractured in a similar way. Like the cuboid, isolated cuneiform fractures are rare, and typically occur in situations where numerous other bones are fractured.

The patterns of cuneiform fractures are similar to cuboid fractures, and the underlying causes are still rotational injuries that involve some form of foot flexion. Cuneiform fracture treatment is similar as well to cuboid fracture treatment, as these bones are tightly bound in place like the cuboid bone by strong ligaments. An exception to this is if there is an associated fracture and dislocation of the metatarsal bones beyond the cuneiform, where internal fixation in the form of wires, plates, and screws must be used to stabilize the bones together to maintain proper spacing.