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Avatar universal

Fractured Cuboid Bone in Left Foot

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.
174 Responses
Avatar universal
I'm interested to know if you've gotten any response to your post??
I also have a broken cuboid bone. About 4 weeks ago, i stepped down (very hard)  on a 6" spike in an overgrown field and crushed part of my cuboid bone. I also went to a podiatrist who put me in a boot/cast and told me to stay off of it...or try to keep it elevated.
I'm trying to stay off of it......but life gets busy.
It's been a month and it's still swollen and painful.
I was told that it would take 8 weeks (approx.) to heal but it seems odd that it still hurts and swells as much as it does.

Any advice or information would be appreciated.
Thanks!
Avatar universal
I too have a fractured cuboid bone. My dog ran into me full speed.I'm going into week 5(wearing a boot and non-weight bearing) and I too am feeling more pain than before! I've been told 6 weeks, but I'm a little worried about whether or not it's healing.

I understand that there isn't much of a blood supply in that area, so avascular necrosis is a concern. And it is always swollen by the end of the day.

Any thoughts on this?
Avatar universal
I'm so frustrated too!!  I'm 8 weeks fractured cuboid-in a walking boot and had been on crutches but just can't handle them anymore!  I still cannot tolerate walking much distance without a lot of pain and I"m still having shooting pain through my foot.  the doctor says the fracture is minor so why does it still hurt so bad??  I've wondered if the boot is what is making it hurt so much.  Does it do more damage to walk on it if it's not completely healed?  any thoughts?
Avatar universal
I to am in the same boat as the rest of you. I hurt my left ankle/cuboid in mid June. i was chasing my 2 1/2 year old son and dog out of the hose and down my garage stairs and missed the bottom step. My wife saw the whole thing and knew righ taway that it was ugly. I got up and walked it off for 2 weeks it was bothering me so it went to see an OS and x-rays were negative go figure! I was given a air cast and was told it was a bone bruise and moderate sprain. 2 more weeks passed and the pain turned it to a burning pain so I went back and aan MRI was performed and low and behold it showed up like a sore thumb a stress fracture to the cuboid bone on my left ankle. I was given the option of a Cam or a cast and I opted for the cast I work a job that I'm on my feet 10 hours a day and I want it to heal correctly if I had a cam I would be walking on it for sure. I was told 5 weeks in this cast. I'm 2 weeks in ans handeling life okay but my cast has loosened up on me and when the joint moves in the cast I can feel the point where the injury is. I have to call him back and maybe have it re casted. He told me once the injury was discovered that it's a 6-8 week recovery buy I'm sure I didn't help things along by walking on it for a month before it was imobilized. I do have some swelling from time to time if I don't elevate it long enough. That's my story and I'm sticking to it. any one else out there that can sare a realistic time table for this to heal?
Avatar universal
I am in a cast for a cuboid fracture.  I fell on an oil spill June 23.  I was told a sprain and after 4 weeks of pain in a boot, they did an MRI.  Like the rest of you, sure enough there was a fracture.  Now I am in a cast.  I go back this Thurs. to have the cast taken off and hoping they don't put me another one, as I still have pain.
Avatar universal
I'm almost 3 weeks in now and I still have pain I'm going to call my OS tomorrow to see if I can get in and have a tighter cast put on. Here is the answer I got back from an ask the expert web site.

http://www.allexperts.com/user.cgi?m=6&catID=984&qID=4650692
Avatar universal
I still have some pain after almost 6 weeks.  I go back to the Dr. on Thurs.  My foot still swells even with the cast.  Let me know what your Dr. tells you.  I checked out your link, interesting.  Thanks.
Avatar universal
How do you ice a hard cast?
Avatar universal
I called my Dr. today and I have to see him in the AM. I hope he says that yep it's loose and let me put on a tighter one for you. I still have 2 weeks to go and my gut feeling is that he's gonna say tack on an extra week you shouldn't still have pain.... best case cenario I don't have one I'm still stuck in this thing for 2 weeks. It is nice though that I can ice it down and after about 5 minutes it feels good. With one of those cam things I'd have to take it off to ice it. I'm not into taking any kind of pain medication so ice is my friend.
Avatar universal
I have one of those felxable ice packs in a velcro sack and just wraped it around the outside of the cast at the ankle area assuming it's a fiberglass cast. ! It's hevan. I went in today and now I graduated to one of those cam walker things for yet another 4 weeks. This will make 7 week total not walking on it. It's really starting to be a drag. I couldn't belive how much my lower leg shrunk down in size. It looks like a tooth pick. By this time next month it ought to look like worse! I'm sure PT is in my future when it's all over and done with. Keep me posted with your recovery and what your Dr. says.
Avatar universal
I feel your pain. I'm now on week 8(6wks non weight bearing and 4 more partial weight bearing). I see my MD on 2 wks but I'm not getting my hopes up.When I began to whine about it all, he told me if I was any heavier( I'm about 120#) I'd be looking at 6more weeks non-weight bearing.That shut  me up. the thing that worrys me is the chance for necrosis is this particular bone. I'm trying to be good, but.....well you know.
I also have a tooth pick leg. And getting a thick waist
Hang in there.
Avatar universal
I'm 5'8" and about 135# my legs look like toothpicks all the time but my recently uncasted one looks like one from a person in from NAZI concentration camp! But seriously This cam is a drag and I've only had it 1/2 a day I should have pushed for another cast. I know it sounds nut but other than the showering I have everything else down pat. This is heavier and very cumbersome. The only reason he put me in this is he said he wants me to streach it out 1-2 times a day. I'm not sure why but This is a pain in the a$$ I went out with my wife to the store and I was whipped by the time we got out. I could have done 2 more laps while in the cast. If it were not for the fact that it loosened up so much I should have kept it the extra 2 weeks and maybe been done with it once and for all. It's still VERY tender to the touch where the fracture is but the joint feels better. Maybe having me streach it out is his way of saying this will help prevent necrosis I didn't ask him. He's Indian and doesn't have all that great of a bed side mannor. Keep me informed as to your status. Like I stated before there Isn't much on "the net" about this type of injury it's rare to say the least but there are a few peopel now with current posts that are in the same boat as us. Take care!
Avatar universal
Is a cam the same as a boot? I  didn't get a cast, just a boot all this time. However, I'm glad to take it off to bathe and sleep. And yes, this is not a common bone to fracture.I work in a Family Practice office, and when asked which bone i broke, i get coments like"that's almost unheard of " and boy, that's rare". But since it is Family Practice, I can't pick their brains like I could if they were orhtopods.
But I'll keep trying.
Avatar universal
This is what I have It's a high cam walker scroll down the page a bit.
http://www.mercymedicaleq.com/resource/products/productList.asp?Cat=71

Yes My best friend is my MD/DO  and he told me the same thing A DO is an ostopath I don't know if I spelled that right but they have an understanding more of the sketal and muscular system than an MD at least that's what he's told me in laymens terms. He said that's very rare!
Avatar universal
I got my cast off today.  I still have some pain, but the Dr. said it is healing.  I still need to use the crutches for 10 days or so.  I am going for pt starting Tues. I go back to the Dr. in 4 weeks.
Avatar universal
How long where you in the cast for? How bad does your leg look compaierd to the other one? How long have you been at this total now? As you can see in the threads I'm in a cam walker now and to tell you the truth I'm in more pain now than I was when I first hurt my self. I'm almost 2 months in. I can't belive that a stress fracture or bone bruise could hurt more 2 months later than it did at first. I'm seriously thinking about seeing a new Dr. about it. Maybe an "American" Dr. . I'm rellay getting discouraged I'm having a hard time finding a happy medium with this walker where I don't have much movemnet in the boot but yet not so must pressure from the straps where it's puching on the area where the pain is. I'm still having swelling as well . To tell you the truth this thing hurts more that the air cast he had me in to start off the whole ordeal. The cast I was In was the most comfortable of the three if you can belive that whenit got to the point where it was loose it wasn't much fun though.
Avatar universal
I had my fall on June 23.  So I am in over 6 weeks.  I wore the boot for 4 weeks and the cast for 2.  My calf does look alot smaller than the other one.  Is your Dr. doing xrays to see if the bone is healing or there is anymore damage?  My Dr. did an xray today.  I asked why an xray, when it did not show the fracture in the first place.  He stated that he could see if there is anymore damage or if the bone is healing by a white line on the xray.  I would check out an American Dr.
Avatar universal
Yes he did x-rays to start and it showed nothing. MRI showed the problem so he said. did a second X-ray the other day after he cut off the cast I was asking my self the same thing If if didn't show up at first why look again other than a reason to charge the insurance comapny?? I don't know... I didn't ask him. He wasn't to gentle during the exam or when he cut off the cast either he was throwing it around like a rag doll. He did apologize when I was grimicing in pain! How long are you in PT for? Why did you go from the boot to the cast? I went from Air cast to cast to camwalker. The cast and walker are both non weight on the leg. I have a job where I'm on my feet 10 hours a day so I'm off work now and I don't want to be screwing around with this for months to come!
Avatar universal
Did he think the bone was healing from the xray?  I am in PT for 4 weeks, 3 times a week.  He said that after a week or 2, I can do the exercises at home instead of going.  3 times a week, who the heck can affor that?  They had me in the boot, because they thought I had a sprain.  When they finally did an MRI 4 weeks into, they saw the fracture.  He then put me in the cast since I still had alot of pain.
Avatar universal
He didn't say he just said he though that the healing has far enough along that a cam walker was in order. He told me to streach it out a few times a day and it really hurts when I do It. I'm not sure if it's from it meing imobile or from the injury. But the pain is the same that is felt at first.
Avatar universal
Ok, now I"m 11 weeks fractured cuboid-my doctor finally put on a cast instead of the cam walker and it feels better except the swelling.  I have been no weight bearing since they confirmed the break with an MRI.  the real problem is that my doctor treats me as though it's all my fault that it's not healing.  Seeing others that are having the same healing issues helps.  Has anyone else had these issues with their doctor??  And any suggestions on how to deal with that-other than changing doctors...And yep, got the toothpick leg too:)  
Avatar universal
Well I'm 5 weeks in since the problem was detected on an MRI I went for a second opinion to a doctor in the same group. He is the foot and ankle "specialist" he looked at the report and at the MRI films and confimed what the first Dr. said except he noticed that the Talis bone was "bruised" as well. so I actually have 2 bones that are bruised. I expressed my discomfort with the cam and that it was twisting my ankle all over the place and he told me that a cam was the appropriate treatment for this type of injury but that a cam doesn't fit everyone properly. He told me I could actually walk out of the office with nothing on my leg but don't walk,bump,twist or jolt the leg. Like that will happen. He offered to re cast the leg if it was more comfortable. I opted for that option As crazy as it sounds It fits my lifestyle better I have a 2 year old at home and it's a track meet all day long so the leg gets beat up a bit. So here I am I'm casted for another 4 weeks that will make 7 weeks in a cast total. He did tell me that actually pegging a time frame is hard because those bones heal slowly due to lack of blood floow in that part of the ankle. he said it would be fair to say 12 weeks out before it actually fells better. I'm 8 weeks since the fall but only 5 weeks imobilized. good luck to you and hope that sheds some light on the injury.
Avatar universal
I am switching Drs. too.  I am upset it took my Dr. 4 weeks to order the mri.  Then casted me for 2.  My foot is so tender and it still hurts.  He siad that when he did the last xray that it was healing.  My fall was June 23
Avatar universal
My ankle is still ver ytender as well. My fall was 6-15. This cast I have now was extra padded around the place where it hurt the most. and even with the extra padding when it swells up it still presses on that spot and it's quite uncomfortable. Like I stated in my last post the dr. said it could still be a whil before it starts to feel better. He told me that if I had indded broken both of them that surgery would be in order due to the slow healing of that part of the foot and ankle. Feel better! keep me posted.


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