Published online Feb 18, 2019. doi: 10.5312/wjo.v10.i2.71
Peer-review started: October 24, 2018
First decision: November 1, 2018
Revised: December 11, 2018
Accepted: January 5, 2019
Article in press: January 6, 2019
Published online: February 18, 2019
Cuboid fractures due to the particular bone anatomy and its protected location in the midfoot are rare, and they are usually associated with complex injuries of the foot. Clinical examination to diagnose these fractures should be detailed and the differential diagnosis, especially in the case of vague symptoms, should include the exclusion of all lateral foot pain causes. Conventional radiographs do not always reveal occult fractures, which can be under diagnosed especially in children. In this case, further investigation including magnetic resonance imaging or scintigraphy may be required. The treatment of these injuries depends on the particular fracture characteristics. Non-displaced isolated fractures of the cuboid bone can be effectively treated conservatively by immobilization and by avoiding weight bearing on the injured leg. In the case of shortening of the lateral column > 3 mm or articular displacement > 1 mm, surgical management of the fracture is mandatory in order to avoid negative biomechanical and functional consequences for the foot and adverse effects such as arthritis and stiffness as well as painful gait. In this review, an update on diagnosis and management of cuboid fractures is presented.
Core tip: The cuboid bone is an essential anatomic element of the midfoot contributing greatly to foot biomechanics. Cuboid fractures are rare and usually associated with complex foot fractures and dislocations. Such fractures require a high level of attention in order to ensure a timely diagnosis. Besides a detailed physical examination, further radiological assessment will identify the presence and type of fracture. Although simple cuboid fractures are effectively treated conservatively, displaced fractures require surgical treatment in order to avoid future devastating consequences. Because of the lack of adequate scientific evidence, the ideal surgical approach is still not universally accepted.