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.

[Kittie69]

I broke my cuboid bone quite badly 4 weeks ago, by just rolling my ankle, i heard it snap.  Was put in a back slab for 2 weeks finally got to see ortho surgeon who told me i wouldnt be needing surgery, and was put in a full cast, which had to be reduced back to a back slab 2 days ago after only 2 weeks of being in a full cast,  due to swelling of my foot and cutting circualtion off in my foot, the pain in my foot is far worse now than when i 1st did it and is having very painful spasms (contraction like even). More Xrays taken 2 days ago show that the bone is still as broken now as it was the day i did it. It is extremely painful, and i cant use them damn crutches anymore i have brusing on my hands from them even. It is impossible to keep it elevated at all times and to keep weight off it.
After reading all your stories I must admit I am more than a little worried especially since the pain is worse now than when i done it, and pain killed dont do anything to help ease the pain.
I wonder if any medical peson has ever even broken one of these bones as they all seem to say 6-8 weeks for a full recovery

[GoldenBC]

Hmmm, I found this site after doing a search on pain near the cuboid bone, and it sounds like me.  I rolled my ankle and broke the base of my 5th metatarsal, and am currently in a boot going on 9 weeks now because it's slow to heal.  However, I have a really painful area behind the 5th met, straight below the ankle, at the bottom of my foot, and on looking at an anatomy chart, it's the cuboid bone.  At first I was thinking it was the tendon, but none of the other symptoms of injuring that tendon match (only hurts in that spot, not further up).  It is EXTREMELY tender there and aches madly esp when I weightbear (only with the boot).  If my 8 week xray report says little healing, I will be referred to an ortho, so the info on this site has really helped me as I will be specific with him.  If I get sent to the ortho I had for my knee, I know he does bone scans so hopefully something would show up there.

That said, I hope I don't have this.  The 5th met thing is proving to be a long, torturous affair, and I don't really want to add a cuboid into the mix...

[CuboidClub]

It's great to read everyone's comments and discover that we're all in the same boat (or boot!) so to speak. I am lucky that I was not misdiagnosed.  I just waited too long to see a doctor.  I sprained my ankle on July 4th in Philadelphia (on cobblestones).  I turn my ankles quite easily, and thus didn't think anything of it.  The next day it was very swollen and I could barely walk on it. I was attending a conference in Phila. and had to walk to and from the train each day.  The first week it was pretty swollen, but I thought it was getting better.  I teach, so I was off all summer, and my normal routine is to go to the gym each day.  This is exactly what I did.  And after 3 weeks, it appeared my ankle was not healing.  I went for my annual checkup and showed my foot to my doctor.  She ordered an x-ray and told me that if it were negative, she would order an MRI.  Sure enough, it was negative, and so I had an MRI.  I applaud my doctor for immediately knowing what to do (no misdiagnosis here!).  And the MRI showed a fractured cuboid.  She referred me to a podiatrist.  He reviewed the MRI and prescribed a CAM boot (air cast) and crutches.  I never used the crutches.  I was pretty faithful wearing the boot the first week, but it became annoying.  And since I have never broken a bone in my body EVER, I guess I didn't take this seriously.  I went back for my 3-week follow-up appointment, and needless to say my doctor was not thrilled.  He took a baseline x-ray for reference and gave me a bone stimulator.  He told me if I did not wear the boot, I'd be in a cast soon.  School started that following week, and I have faithfully been wearing the boot.  However, since I am on my feet all day, the swelling has returned and increased, and I sometimes have a dull ache.  I do try to elevate my foot when I am home at night, but wearing the bone stimulator for 3 hours at a time is not always feasible.  Wondering what everyone else thinks of this (and whether I might have to be put in a cast).  I also feel that my ankle is now sore again due to having to carry that heavy boot.  

[Sharon1210]

As the story seems about the same for all.  Misdiagnosed to begin with here.  PCP xrayed and told me it was a severe sprain it will take about 6 weeks to heal, mind you I work about 10 hours a day on my feet ugh.  I was off work for 2 weeks, at that point I was told I could go back to work.  Low and behold I suffered thru so much pain for 4 weeks.  Then was referred to Foot Specialist, re xrayed and he saw the Cuboid Fracture and the 5th Medatarsal had snap part off.  Followed this up with MRI confirmed the findings.  Out of work again 2 weeks, returned to work with CamWalker,what a joke working in these on your feet.  Did that about 6 weeks.  Then I was given a bone stimulator as xray didn't show any improvement.  Did this and still in the CamWalker for 4 weeks.  No improvement.  ugh I was told surgery is the only thing.  He did PRP injection in surgery (drilled 10 holes in bone and injected the bone cells from my blood) of course removed the snapped off bone.  Needless to say I am in week 7 postop still in allot of pain, allot of swelling.  I'm in 9th month of the begining of this nightmare.  Been off work since July 16, very frustrated and wonder if I will ever be able to work on my feet again.  I was told from the beginning this is a very odd break, and very difficult to get it to heal.  I never dreamed this.  I seriously have my doubts if this will ever heal.

Sharon Frustrated

[Countrygirl00]

My father broke his cuboid back in June and has had the same run around from his PCP since.  He finally talked the Dr into sending him to an ortho and he ordered an MRI.  Nothing else has worked for him and how has to have surgery.  The ortho Dr said that he will have to put a plate in his foot and fuse the bones back together.  Will let everyone know the outcome as soon as he is thru it!!

[pj5910]

In June I stepped off a curb and right into a pothole. My foot went 90 degrees to my right leg. Seven weeks later, 2 complete set of x-rays and 2 MRI's they have diagnosed the injury as a fractured cuboid. As it has turned out I was telling them all along exactly where the pain was. I was given crutches and they made a plastic mold that I strapped on my leg and around the bottom of my foot for the first few weeks and then I was put into a walking boot, which I am still in. Three weeks ago I finally started PT but no weight bearing activity. My foot still aches and certain movements shoots a sharp pain along the top and down the side of the foot. My doctor assures me that I will be 100% but has not given me an exact date when I will be completely recovered. I ride a recumbent bike at home at least 30 minutes a day and hope to start taking short walks, maybe a couple of blocks. I am still skeptical at this point that I will be 100%.