Avulsion fracture of the dorsal cuboid bone

Case contributed by Dr Mohammad A. ElBeialy

Presentation

Lateral foot pain. Trauma since 1 year. Diagnosed with tendinopathy and pain since then. Initial radiographs were reported as unremarkable and MRI was requested.

Patient Data

Age: 37 years
Gender: Female

Marrow edema signal is seen at the dorsal surface of the postero-lateral cuboid bone.

Avulsion fracture of the dorsal surface of the postero-lateral cuboid bone is seen.

Annotated image

Case Discussion

Isolated cuboid fracture is a rare fracture. Fracture cuboid is uncommon (about 5 to 10 percent of the tarsal fractures) and is frequently associated with lateral column fracture or tarso-metatarsal joint fracture–dislocation. So full examination of the foot for other fractures is a must. Routine radiographs must include oblique medial view.

Avulsion fractures are the most common of the tarsal fractures representing about 70% of the cuboid fractures. Other cuboid fractures are stress fracture, body fracture or fracture–dislocation of the cuboid.

Avulsion fractures of the cuboid mostly occurs at the insertion of the plantar calcaneo-cuboid ligament. Others may be along the lateral border of the cuboid due to cuboid adduction on the calcaneus, posing tension on the lateral calcaneo-cuboid ligament.  

Body fractures of the cuboid are usually intra-articular and crescentic-shaped and due to rotational motion trauma to the forefoot in plantar-flexed position. The most common mechanism causing a body fracture is a nutcracker fracture and commonly associated with a navicular fracture.

 

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