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Cuboid Fracture

I fractured my Cuboid bone 9/1/07.  Initially I was told it was a "contussion".  I walked on it for two weeks until confirmed with an MRI.  I was placed in a cam cast for 10days then a hard cast for four weeks.  I had the cast removed 10/16.  My Docter told me to gradually wean myself out of the cast and he will see me as needed.  No PT.  I'm an RN so I know how to take my time and listen to my body.  But no PT?  Is that normal?  My ankle and foot are very week.  I have now developed severe pain in the area of injury/heel and ankle.  I called and made an appt.  I believe I have Plantar Fasciitis with heel spurs.  Anyone else have these same problems.  Is 9.5 weeks a long time?
22 Responses
Avatar universal
I agree it is unusual not to advice physiotherapy. The weakness of the ankle and foot are understandable due to disuse and you should regain power slowly over time. Plantar fascitis may or may not be related to the fracture itself if it has developed recently . The severe pain may be explained by the plantar fascitis and the heel spurs. You need a thorough evaluation of your medical problems and follow this with appropriate treatment. You have already fixed the appointment and I recommend you go ahead and clarify all the doubts you have with your treating physician.
I'm going on just over 2 years they told me that it was a nutcrackers foot and just would give me injection every four months when it started hurting again I found out yesterday from my aunt that a nutcrackers foot is a fracture of the cuboid i'm so mad I just want the surgery to see if that helps it because the injection are not like I said just over two years
Avatar universal
The cuboid bone is a large bone and fractures of this bone are often missed on regular xrays.  If the fracture was only picked up on an MRI then it wasn't a bad one.  Healing time is totally dependent on the individual, but is usually complete in 6 weeks.  If you are diabetic you can plan on a longer period of time depending on your body's ability to heal.  If you are osteoporotic it also lengthens the time it takes to heal.  When in a cast, the muscles of the foot and ankle will weaken from lack of use.  It can take a long time to get back the old muscle strength, again depending on your own overall health.  Pain in the muscles are a normal "side effect" of casting the foot.  Use is the best physical therapy for the foot, so it is not so unusual for a physician to forego physical therapy for your type of injury.  If you have bone spurs, surgery can be performed to remove them.  If you have an inflammation of the fascia of the sole of the foot, you can get steriod injections to bring down the inflammation but it doesn't usually work very well and is very painful to suffer through.  Plantar fascitis is often successfully treated with cold foot baths done several times a day for about 10 days.  The cold (not icy) foot bath reduces the inflammation in the fascia allowing the body to heal.  It is good that you are doing a follow-up so keep the appointment. Get xrays to diagnosis the problem.  Normal xrays will show any spurs and also will diagnose plantar fascitis.  While you are waiting for the appointment, try the footbaths.  good luck
Avatar universal
Check this out. I'm 5 months in and stiull having issues The cuboid area feels just fine but I'm having ankle issues. Read this thread....
Avatar universal
I'm a dumb A$$ here's the thread sorry!
Avatar universal
oh my gosh.  I am dealing with the same kind of pain.  I was in a car accident at the end of august.  I had a lot of other injuries, but I was just told that I had a contusion to my right foot.  About a week ago I requested a copy of my medical records from the hospital due to issues pertaining to other parts of my body.  While reading through the records, I discovered that I had a cuboid fracture to my right foot that I was never told about.  I am pissed!  I am only 22.  I have been dealing with pain ever since the accident.  I can't go rock climbing because of the pain.  My doctor just told me that it would get better, and that I had to give it time.  How rediculous!  I have scheduled an appointment with a podiatrist.
Avatar universal
I had a similar experience. I fell, had terrible pain and negative x rays. An MRI 3 weeks later discovered a cuboid fracture. I was, then placed in a hard cast for 4 weeks . After falling with crutches the cast was replaced with a cam walker for 5 weeks. Now, 14 weeks after the fall, I am still in pain. I recently saw a podiatrist who diagnosed peroneal tenosynovitis and prescribed a walking sling (very uncomfortable) and physical therapy. I hope this helps, this has gone on way too long.
Any suggestions?
Avatar universal
To: cuboid people
hello - similar run around -- need some answers!  
     twisted ankle in Sept - all xrays negative.  Went to see pod. - cortisone shots, did not help.  April went to doc again still complaining,bone scan, and MRI.  Ortho was going to do a "debridement" but then had a CT scan and he sent me to an foot/ankle ortho.  This new guy puts me in a cam walker for 8 weeks.  How can that solve my problem when it happened in Sept?  Does everyone in a cam get to take it off at night?  MRI said stress fracture cuboid bone near calcaneal cuboid joint.  I saw the CT scan with the first Ortho who I really like.  It showed this wedge shape area in my cuboid that he explained was probably dead bone and that he wanted me to see an expert - and that guy just puts me in a cam.  Has anyone needed a surgery for this bone / area?
Avatar universal
hi this sounds similar to my daughters problems she had a trolley fall on her foot but took her to a & e they took 2 xrays and said theres nothing on them ,took her back 4 days later and got sent away !!!! its now 9 days and its still swelling up,still bruised and she can't weight bear and is suffering continuing pain , am i being a worry parent or do you think like me that something is wrong as she should be starting to feel better now ????? dont like to go back again too soon as i dont want to be a time waster
please help
many thanks
Avatar universal
Yes!  Keep going back and demand that they do an MRI ....I fell standing on a chair at school and blew it off for two weeks and just babied it but it continued to feel sore and bruised and some swelling.  I finally went to Podistrist and he told me I had a cuboid stress fracture and put me in a soft boot cast for 6 weeks (just got it off today!!!!) but my foot and ankle very week and I'm scared to walk on it so actually looking forward to therapy.  Please go to another doc if that's what it takes... good luck with your daughter and no, you are being a GOOD mom!
Avatar universal
hi , thanks for your reply since last post i have taken my daughter back and she has seen an ortho who was great ,she is currently having physio therapy and goes back to ortho in 2 wks to decide is she needs further tests she's still in same condition but hopefully now things are going in the right direction i'll keep you posted ,hows your foot ? ? ? good luck with your recovery
Avatar universal
(I'm in the UK, so am dealing with the NHS - which I normally have no complaints about.  However...)

Four weeks ago I fell horribly on slippery ground. After about 40 minutes, my left foot had swollen to the point I couldn't walk on it. I had an x-ray that day and was told it wasn't broken, and to walk on it as pain allowed. I did that - barely walking on it and when I did, only gingerly - and it felt worse and the swelling got worse. My toes were all swollen and moved out of shape and the ball of my foot was swollen as well. One and a half weeks from the fall, I went to my GP and he said to stay off it completely, keep it raised and continue taking the anti-inflammatory I'd been taking (at the highest strength/dosage possible) since the fall. (And continue with my pain meds..!) If it wasn't better in about 4-5 days, he told me to get another x-ray at A&E.

Two weeks + 1 day after the fall, I had another x-ray, and the A&E doctor told me my foot was in fact broken and I was fitted with a plaster of paris cast. I was given a follow up appointment for 2 weeks later and told to continue with the anti-inflammatories and keep the foot elevated at all times.

I went to the follow-up this past Tuesday and now I'm told it isn't broken, only sprained, and am scheduled for physio on Monday!!!  When I questioned the A&E diagnosis, the "consultant" muttered something about junior doctors!  He was abrupt and insulting - and didn't even know/acknowledge the facts of my injury.  He wrote on my physio referral that it happened 2 weeks prior, not 4 weeks, i.e. the date of my visit to A&E, showing he didn't even read any notes/info from that date.

The swelling hasn't gone down at all since the day after the fall (the day of the fall it swelled up so much it didn't even look like a foot). The pain is exactly the same level, in the same localised places, and I still have a bruise running down the middle of the bottom of my foot. I can't stand on it without an incredible amount of pain - can't even hold it upright when sitting down with my leg stretched out. I get very sudden and sharp pains.

Should the swelling and pain be at exactly the same level 4 weeks on if it's a sprain? And if it is a sprain - an dthe pain and swelling are at the same level 4 weeks on - am I really ready for physio??

In the meantime, whilst the foot was in the cast, I developed a strange feeling around my big toe, like I'm wearing flipflops (with the thong between my big + next toe), as well as the feeling that there is a band around the base of the big toe. I overheard the "specialist consultant" I saw yesterday dictate in his notes that I had this pain (in the wrong foot!!!) and that he didn't know how to explain it - but no suggestion that we try to figure out what's causing it!

I'm out of work, in pain and scared that I've been misdiagnosed more than once.  Daily, I'm on 150mg diclofenac sodium and up to 8 tablets of 30/500mg Solpadol (though I've been trying to keep it at 4 tablets because otherwise I get so sleepy I can barely think or speak.

Please help.
Avatar universal
Need to add - they took the plaster cast off at Tuesday's appointment, and I now simply have a Tubi-grip around my (thinner!) calf, ankle and down to just short of my toes.  The pad of my foot is swollen as well.  My heel is beginning to alternate between actually hurting and going "numb".

Thanks to anyone who can help.
Avatar universal
Wow, I really know how to clear a room, don't I?

Thanks for nothing.  Still in pain - back to work, walking up to 3 miles a day on a foot that still swells and hurts and looks deformed.  In "rehab" class 1 morning a week and afterwards in so much pain.  Keep getting told this is "normal".  Now find that I have joint hypermobility syndrome and that's why it's taking so long to heal and hurting so much.

Not sure why I "updated" - but just felt like talking even if no one is listening.  Cheers.
Avatar universal
Avatar universal
Apparently the Cuboid can be difficult to diagnose.   I am an RN and work in Radiology, after smashing my foot and knowing without a doubt I broke it, I had x-rays done.  A friend of mine who is a Radiologist (and a damn good one) looked at the films and said initially he didn't see any fractures.  But after further evaluation said the cuboid might be fractured.  I had a CT scan done and not only was it broken, it was exploded.  I then had and MRI done to ***** for soft tissue damage, which there was some ligament and muscle damage also.
I opted to have surgery in which a bone graft was done and X plate and screws placed to hold it together.  I am 2 and a half weeks in post surgery and now in a cast.  So I do not have a long term recovery report.  I have been told it is slow healing and will take a while.
Anyway, my point is the Cuboid often does not show up well on x-rays so don't be so surprised if it is missed and then later caught on CT or MRI.
Avatar universal
I'm in the same boat --- I was in an automobile accident 10 months ago, I got hit nearly head on by a dump truck and have had worsening foot pain since. They thought initially the pain was from a nerve in my hip, then we did the MRI that showed swelling in a nerve of the foor & ws diagnosed with a neuroma. Now I've finally seen a podiatrist who says I do have the neuroma but also the cuboid fracture.  10 MONTHS!!  They want me to come in tomorrow for a cam walker (whatever that is) but I'm just hoping that it is going go heal without surgery. You'd think it would have done so over the course of the last 10 months if it was going to.
Avatar universal
Sometimes a simple X-ray of the foot reveals more than an MRI and other diagnostic tools. the cuboid fracture might have been missed or may be a hairline fracture has evolved into full fracture. As you did not give rest during the recent past the fracture has not healed, so now with walker, bandage, support shoes, splint or any method which would immobilize that part so that a secondary fracture healing would take place is the method of treatment. Surgery is an option, but always try conservative to start with.  Take care!
1463099 tn?1286004452
sir before 5 days in a accident my left foot cuboid bone fractured. it's seen in 2nd x-ray after 2 days . then i go to physician he  actioned and plaster of pop for 5 weeks . now i am feeling some pain in night. sir told me that how much time is taken for normal foot for running & playing. it is go better without any surgery??    

in waiting ur answer.

i am worried about it.

Ravi Kant Pandey
1831059 tn?1317941752
i chipped my cubiod ( showed up on xray) in my left foot nearly 7 wks ago ( fell down a step and twisted it badly). i was in pot (hard cast) with weight bearing for 2 wks, soft boot for 2 wks and crutches for a further 2. i have been having 3 wks of physio and the pain is still unbearable over the cuboid and radiates all over the top/side of my foot. I keep getting told that its normal to have pain when you move it, but surely i should not be in exactly same amount of pain as when i 1st had the injury? it gets so bad i cry. I've tried co codamol & diflofenac and nothing dulls this constant throbbing ache. I am going to go back down to a&e in the morning ( will be th 2nd time in 4 wks that i have gone back). i am worried that the bone still hasnt heeled?
Avatar universal
interesting - I did have my foot go out from under while walking an incline ramp at an airport.  ICED the swelling - walked slowly - and I am an active person -- gym 3 - 4 x's weekly -- cycling --
my injury was 2 weeks ago -
went to podiatrist -- diagnosed cuboid fx - wants me in cam walker - and they did not fit me accurately -- going for another opinion -
not sure anything but time will help with healing -- 6 - 8 weeks
I have been advised to stay off the foot --
any thoughts?
Avatar universal
Hello, I am in a similar situation. 1 month ago i went running (only 3 miles) but it was my first run in a couple months and i forgot my running shoes so I ran in my minimus shoes i had in the car. Afterwards my left foot ached really bad so 1 week later i went to the dr. x-rays (did not see a fracture) and he sent me on my way. I cam back 2 weeks later because it was nto getting better and i was limping pretty badly (had stopped running, working out, everything) he sent me away again and told me to wait one more week. Went into today, he did x-rays (barely looked at them) then ordered a bone scan. He gave me a walking boot/cast and told me  if it hurts at all to walk in the boot use crutches till he sees me Thursday for the results. He think it maybe a cuboid fracture and its been a month since it happened. Any thoughts or suggestions? I have stopped taking Ibuprofen since it slows healing but its sore all the time now and cant really tell if i am hurting it more by not being on crutches, though i do NOT want to be.
Avatar universal
I hope your foot is better. I've been searching for recent entries here, as I have a cuboid avulsion (bone ripped by ligament) fracture that is most likely healed but taking its time about the swelling.
I'm searching for ways to avoid or limit swelling.
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