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From Cast to Recovery: Treating Cuboid and Cuneiform Fractures
Published: Apr 04, 2024
Cuboid and cuneiform fractures can be challenging injuries, but with proper treatment, most patients make a full recovery. Learn about the treatment options available and what to expect during the healing process.
Conservative Treatment: The First Line of Defense
For many cuboid and cuneiform fractures, especially those that are non-displaced or minimally displaced, conservative treatment is the go-to approach. This typically involves immobilization in a short-leg walking cast or a CAM walker boot for 6-8 weeks. During this time, weight-bearing may be restricted initially, gradually increasing as healing progresses. Ice, elevation, and compression can help manage pain and swelling in the early stages.
Surgical Intervention: When Conservative Treatment Isn't Enough
In cases of significant displacement (more than 2mm), comminution (multiple bone fragments), or associated injuries, surgery may be necessary. Surgical options can include open reduction and internal fixation (ORIF) with screws or plates, or in severe cases, fusion of joints. The goal of surgery is to restore proper alignment and stability to the midfoot, which is crucial for normal foot function.
Rehabilitation: The Key to Full Recovery
After the initial period of immobilization, whether treated conservatively or surgically, rehabilitation plays a crucial role in recovery. This typically begins with gentle range of motion exercises and gradually progresses to strengthening exercises and activities that improve balance and proprioception. A structured return-to-activity program is essential, especially for athletes or highly active individuals.
Long-term Management and Prevention
Even after full recovery, some patients may benefit from ongoing management strategies. This can include the use of orthotics or supportive footwear to help distribute pressure evenly across the foot. For athletes or those in high-risk occupations, proper technique and equipment can help prevent future injuries. Regular follow-up with a healthcare provider is important to monitor for any long-term complications.
Frequently Asked Questions
Most patients return to full activity within 2-3 months, but it can take longer for complex cases.
Surgery is typically only needed for significantly displaced or complex fractures.
Initially, weight-bearing may be restricted, but is gradually increased as healing progresses.
Some patients may develop arthritis or chronic pain, especially if the injury was severe or mismanaged.
Return to sports is typically allowed when you can perform sport-specific activities without pain.
The Road to Recovery
With proper treatment and rehabilitation, most patients with cuboid or cuneiform fractures can expect a full recovery and return to their previous level of activity.
References
- Eiff MP, Hatch RL. Fracture Management for Primary Care, 4th ed, Elsevier, Philadelphia 2020. p.332.
- Schildhauer TA, Coulibaly MO, Hoffman MF. Fractures and dislocations of the midfoot and forefoot. In: Rockwood and Green's Fractures in Adults, 8th ed, Bucholz RW, Heckman JD, McQueen MM (Eds), Lippincott Williams & Wilkins, Philadelphia 2015. p.2690.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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