Old nutcracker fracture of cuboid

Abstract

Nutcracker fractures of the cuboid (compressed) are rare and often missed at an initial visit. We report a 21-year-old patient presented with a 9 months old cuboid fracture. He presented with a localized pain around his left foot. Radiograph revealed the shortening of the lateral column with old cuboid fracture. The lateral column of foot was reconstructed. The patient remained symptom-free and no radiographic evidence of recurrence was observed 1 year postsurgery.

Keywords: Cuboid fracture; nutcracker fracture; old cuboid fracture; treatment.

Figure 1

Radiograph of the left foot (a) preoperative oblique X-ray showing compressed cuboid (b) preoperative anteroposterior X-ray showing unclear lateral column (c, d) preoperative CT scan showing that the lateral column was compressed

Figure 2

Intraoperative clinical photographs showing (a) intraoperative distraction. The cuboid was sawn in half from the coronal plane and then was distracted, (b) Intraoperative grafting. Allogeneic bone was grafted, (c) Intraoperative fixation of the plate. “X”-shaped plate was placed over the cuboid dorsally and laterally which did not crossover any joints

Figure 3

Postoperative anteroposterior (a) and oblique (b) radiographs showing reconstruction of the mid foot after surgery

Figure 4

(a) Bilateral comparative anteroposterior radiograph of foot at 1 year followup showing length of lateral column was equal to the right, (b and c) standing comparative weight bearing radiograph of feet at 1 year followup showing flattening of arch on normal side persistance of arch on affected side suggestive of stiff foot on affected side (side view)