Fractured Cuboid Bone in Left Foot

[kmcosgrove114]

Right before the memorial day holiday I got up from the desk in our home office and noticed my left foot was really hurting me. I was limping around as I got the kids to bed and thought perhaps when I was sitting at the desk that maybe I overstretched the foot and it needed to just calm down. By 4AM the next morning I made the decision to go to the ER as it was hurting that bad.

Because I had not recalled falling or tripping, no xray was done and I was told I had plantar fascitis (sp?). They allowed me to leave with crutches and pain meds.

I did a follow up with my primary the next morning - he sent me for an xray to be sure nothing was broken. The report he got back from the xray showed nothing, or so it said.

I stayed home from work for 2 days thinking that between those 2 days and the long holiday weekend, I would be much better the following week. However, the pain continued and I noticed after work the next Tuesday my foot was very swollen.

Our onsite nurse at work suggested asking my primary for an MRI to ensure there was no break in the foot or ankle. I called and scheduled the MRI for 6/4 - almost 2 weeks since the initial symptoms had started.

Meantime, I wore a walking shoe we had left over from other toe injuries that the hospital had given us mainly because my foot hurt more when it was in a sneaker and the walking shoe just had soft velcro closures.

I got the MRI done and went to work. The primary called me around lunchtime that day and said the MRI showed a cuboid bone fracture in the left foot and explained that this bone was right where I was indicating alot of pain.

He also wondered how I broke that particular bone and suggested that it could have been a stress fracture where you do an activity every day and at some point the bone cannot handle the activity and breaks. Also, I had given birth to my 2nd child a few months prior and was very anemic the entire pregnancy - they thought this could have been a contributor as well to the bone breaking.

He told me to see an ortho Dr. that day as I needed the foot stabilized in a cast or cam walker.

My regular orth Dr. was in the process of relocating his offices to a new space (he had done 2 knee surgeries on me) so I was forced to call any ortho Dr. in the area. The only Dr. who could see me that day was a podiatrist who worked within a large group of ortho Dr's in the area - my primary assured me that a podiatrist was just as good to address the break so I made the appt.

I found out once I was there that the break was actually seen on the xray from 2 weeks prior - apparently whoever read the xray and did the report overlooked it so in essence, I had been walking around with a broken foot for 2 weeks. The MRI simply confirmed everything.

I was put in a cam walker and told it was 6 weeks minimum to recover. I was instructed to only take it off to bathe and the rest of the time I had to wear it.

As much as I was relieved to find an answer to the issue with the foot, I knew this was going to be hard as I just had my 2nd child the end of 2006 and my husband works 2 jobs. They did not instruct me to stay out of work - they simply said rest it as much as possible.

I elected to stay out of work for 2 days and then return after that in an effort to get the swelling down.

I am currently in week 3-4 and the foot started really hurting me last week and continues to hurt just as much as it did when this first happened. In addition, my 2nd toe is numb and it is not from over tightening the cam walker - I have been very diligent in ensuring the boot is not on too tight.

I did notice with the 2nd toe that when I press on the top of the toe in the corner by the nail, I get alot of pain and wondered if maybe it was an ingrown nail - never had one so I am unsure how it would feel and can an ingrown nail cause numbness?

Needless to say I caved as the pain became more then just a distraction and I first called my ortho and found he was out on vacation this week for the 4th of July holiday. So I called the podiatrist office and bumped up my 5 week follow up appt. to this week (Thurs) as I felt that having pain at this point wasn't normal........my fear is that the foot is not healing for some reason and they will either continue with this boot for more time, put a permanent cast on me or say only surgery can repair.......the last 2 options I really have no inclination to do as it would severly incapacitate me in being able to care for the children.

My questions:

1. should a fractured cuboid hurt this much at the 1/2 way mark (3-4 weeks in cam walker)?

2. what am I looking at realistically if it appears that the break is still there and not healing?

I have found limited information on this particular break in this particular bone and am very frustrated in having to wear a boot almost 24/7 and now it hurts more then when I first injured it.

At home I have 4 floors in the house so everything is stairs - by the end of the day it feels like I am lugging around 50 extra pounds on the leg when I trudge up and down the steps.

Any information reg my partiicular injury and what the possible reasons for the pain to start up again would be appreciated as well as what I am realistically looking at if this week's xray shows it is not healing.

Thank you in advance.

[Inpain68]

I walked on my foot in pain for several weeks until I broke down and went to see my family dr. The one I normally see was on vacation so saw a partner. He took x-rays and said I had high arches causing Metatarsalgia, but looking that up on the net the symptoms were totally wrong. I went to specialist the next week. They took more x-rays and found a stress fracture on my cuboid bone. I had been walking on it all this time. She put me in a boot. She said I was good to work. ( I work in retail) I am a week in and am in more pain now then in the beginning. I am wondering why I am allowed to put weight on it, seems like everything on net says should be non weight bearing for first couple of weeks.

[xxCatelynxx]

I just fractured my cuboid about 4 and a half weeks ago and i to am feeling the pain right about now, but the weird thing is that i had an x-ray yesterday and it's said mine has healed. I have a hard fiberclass cast so i can't move mine around so i can't tell if it's just me being a hypocondriac???
Is this normal??

Thanks :D

[scrubbiegirl]

I fractured the cuboid bone in my left foot just over 8 weeks ago, after falling over at work (my foot slipped off a paving slab and turned inwards).  I felt an immediate sharp pain but was able to walk so assumed I had sprained my ankle.  I had two days off already rostered, so I rested and did the RICE treatment, but after three days the foot was still very swollen and it hurt to move my toes, so I went to see the local GP who precribed a splint and some painkillers and also ordered an xray 'just to make sure'.  Luckily the fracture (a small, 'tearing' type break) showed up straightaway on the xray and I was in a weight-bearing knee-length boot for 7 weeks (black with velcro straps) which I only took off to take a shower, I had to wear it day and night.  I was told not to drive and that I could walk but only a little, and I was signed off work for the whole 8 week period.  
Well, after my fourth set of xrays last week, my bone had finally healed and the boot came off - about time, I think it was about to walk off my foot and take a shower itself! (despite bathing my foot every day and spraying the boot with antibacterial liquid! The boot was also very heavy and, because of the difference in leg lengths, caused back pain and pain in my good leg)  I have a prescription for physiotherapy but I have already gone back to work three days ago.  I have never felt so tired in my life - after spending eight weeks planted on my sofa, going back to a very physical job that involves a lot of walking and being on your feet is exhausting and painful.  The doc said I should take it slowly to start with, but how slowly?  I haven't received much advice so far on how far I can push myself and I think I overdid it by working full-time 24 hours after taking the boot off.  No fault of my employer's, I hasten to add, they have been very understanding.  At the end of yesterday's work, my left foot and ankle were almost twice the size of the right one, even after having sat down for most of the afternoon.   Fortunately that seems to have alleviated today but I am concerned, like most of you, with the length of time I might need to make a full recovery of my foot's function.  Movement is getting a little easier but coming down stairs still feels very stiff and unnatural and I am still limping noticeably.  
Just thought I'd add my penny's worth to the forum, it's been very enlightening (if a little worrying) for me.  It's hard to believe a slip that took about a second could cause so much trouble!
    

[footdoc333]

Wearing a fracture boot for prolonged periods of time can be very trying.   Especially for people who must continue to function on their feet.  An Evenup device makes this much easier.

[GoldenBC]

Saw the ortho, he diagnosed peroneal tendonitis, prescribed a special orthotic to take pressure off the area, told me to take anti-inflammatories and come back in 6 weeks.  Well trying to get the orthotic correct is a nightmare -- the orthotist got sidetracked by the 5th met break and offloaded that area, not the cuboid, then said he would cut out the cuboid area when I said it hurt to have pressure there, and he did, but then filled it in with soft rubber!!!  So I have to send it back again.  I've been to physio and she says it's not tendonitis, she thinks there's something wrong with the tendon.  My foot and ankle are swollen enough that I have to wear a shoe 2 sizes bigger and even that is tight sometimes.  Can't handle ANY lateral arch support in a shoe, so I can only wear skater shoes.  I think it's possibly OS peroneum syndrome, and will bring it up with the ortho in 3 weeks when I see him again.  My GP has ordered a CT scan, but not sure when that will happen.  Hopefully before I see the specialist again!

[GoldenBC]

Well, as I stated on Dec 31, I broke the base of my 5th met, and it wasn't healing and I also had tenderness, burning and pain where the cuboid bone is.  At the 8 week xray, there was no further healing of my 5th met and I was referred to an ortho. .... What with Christmas, a death in my family, and the ortho being away, I finally got a call from his office today, at the 12 week mark...  And his secretary said that, quote "He says he doesn't need to see you, that it's healed if you don't have any pain."  Hello?  There was no healing on the last x-ray, and I *do* have soreness and pain, even with the boot.  Yes, it's been getting better, I can now put full weight on it and use only one crutch for balance around the house, but that spot (base of the 5th met and the cuboid bone area) still burns and aches, esp. at night.   I can't stand the weight of the duvet on that area even.  Waiting to hear back now that I said that.  Maybe the 5th met fracture has healed more by now (not sure how he'd know that unless he has ESP as I've not had any x-rays in the last 4 weeks...) but I definitely have something else going on, and would like the bone scan to see if it's a cuboid fracture.  If it's a tendon issue, then I want to know what I need to do for that.  I've tried putting a shoe on since the phone call, and it feels like I have a sharp, hot rock under the cuboid/5th met on my foot.  That doesn't seem right after almost 13 weeks now.  I expect some soreness in the arch, my heel, etc. due to muscles/ligaments not being used, but this is a deeper soreness.

I guess time will tell.....