A Cuneiform fracture is an injury of the foot in which one or more of the

Cuneiform bones There are three cuneiform ("wedge-shaped") bones in the human foot: * the first or medial cuneiform * the second or intermediate cuneiform, also known as the middle cuneiform * the third or lateral cuneiform They are located between the navicu ...

are fractured. The annual incidence of cuboid fracture is 1.8 injuries per 100,000 population.

Signs and symptoms

People who have suffered acute fractures to one or more

cuneiform bones There are three cuneiform ("wedge-shaped") bones in the human foot: * the first or medial cuneiform * the second or intermediate cuneiform, also known as the middle cuneiform * the third or lateral cuneiform They are located between the navicu ...

typically have excruciating pain over their dorsal or dorsomedial foot. They also have trouble walking on their toes and bearing weight. Usually, there is a region of localized

ecchymosis A bruise, also known as a contusion, is a type of hematoma of tissue, the most common cause being capillaries damaged by trauma, causing localized bleeding that extravasates into the surrounding interstitial tissues. Most bruises occur clo ...

, tenderness, and swelling between the Lisfranc and Chopart joints.

Causes

While cuneiform fractures are fairly rare, the most commonly fractured cuneiform bone is the Medial cuneiform, typically the cause of a cuneiform fracture is by

physical trauma Injury is physiology, physiological damage to the living tissue of any organism, whether Injury in humans, in humans, Injury in animals, in other animals, or Injury in plants, in plants. Injuries can be caused in many ways, including mechanic ...

(direct blow) to the cuneiform, as well as the result of an

avulsion fracture An avulsion fracture is a bone fracture which occurs when a fragment of bone tears away from the main mass of bone as a result of physical trauma. This can occur at the ligament by the application of forces external to the body (such as a fall ...

and a result of axial load, but can also be the result of a stress reaction that progressed with continued weight-bearing and

physical activity Physical activity is defined as any voluntary movement produced by skeletal muscles that requires energy expenditure.Global Recommendations on Physical Activity for Health, 2009. World Health Organization. Geneva, Switzerland. Accessed 13/07/2018 ...

Diagnosis

Cuneiform fractures can be very difficult to diagnose because of the complex overlapping articulations of the midfoot, which can make them invisible on plain films. Therefore, identification might need for more sophisticated imaging, like CT or

MRI Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to generate pictures of the anatomy and the physiological processes inside the body. MRI scanners use strong magnetic fields, magnetic field gradients, and rad ...

Treatment

A cautious reduction is necessary for dislocated

, regardless of the best time to begin therapy. The right kind of

internal fixation Internal fixation is an Surgery, operation in orthopedics that involves the surgical implementation of Implant (medicine), implants for the purpose of repairing a bone, a concept that dates to the mid-nineteenth century and was made applicable fo ...

needs to be selected after a dislocation has been reduced. When it comes to treating fractures, casting seems to work best for nondisplaced fractures, and open reduction and internal fixation with screws seems to work best for displaced fractures. K-wires can be used to temporarily transfix isolated dislocations and fracture dislocations; these wires are usually removed after six weeks.

References

External links

AO Foundation
Injuries of ankle and foot Bone fractures {{Fractures