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A cuboid fracture that is non-displaced means that the fracture fragments, although broken, are not shifted and are in proper alignment. Nondisplaced cuboid fractures can occur due to repetitive stress on the foot and direct trauma to the foot. Cuboid crush injuries are known as “Nutcracker fractures”.
Non-displaced cuboid fractures are treated differently from displaced cuboid fractures. In most cases, surgery is not needed.
If you suspect that you have sustained a cuboid fracture, make sure to see a local foot doctor. Your doctor will diagnose your cuboid break using imaging. Your doctor will assess where the fracture is, whether the fracture is comminuted (fracture has more than 2 fragments) and whether the cuboid aligns properly with the joint.
Immobilization for Non-displaced Cuboid Fractures
If you have a non-displaced cuboid fracture, you will need to remain off of your feet in a cast boot for 6-8 weeks. This is because bone healing typically takes 6-8 weeks.
To help you stay off of your foot, you can use a knee scooter. This can help keep pressure off the foot.
In most cases, you can remove your cast boot to shower. However, if your doctor recommends you wear a hard cast, you can use a cast protector from Amazon to help keep your cast dry.
When Can You Start Bearing Weight After a Cuboid Fracture?
Your doctor will order x-rays of your foot every 3-4 weeks after you sustain the cuboid fracture to determine whether bone healing is taking place.
After 6-8 weeks once the bone has healed, you can start bearing weight on the foot.
It’s best to bear weight in a cast boot for 2 additional weeks before transitioning to walking in athletic shoes.
It’s important to follow the appropriate cuboid fracture protocol for weight bearing because premature weight bearing can cause the cuboid fracture fragments to shift.
Wearing an ankle brace for the cuboid fracture once it has healed can be beneficial. The Zenith ankle brace works well to support both the foot and the ankle.
Wearing an ankle brace can support the ankle, especially if tendon injury occurred. The peroneus longus tendon that passes along the bottom of the cuboid bone is often injured during trauma. An ankle brace can help stabilize the ankle and protect the tendon.
Your doctor may suggest that you wear custom orthotics because orthotics can help redistribute pressure away from the fracture site when you walk.
Physical Therapy for Cuboid Fractures
After staying off of your foot for 6-8 weeks, your leg muscles may feel weak and your balance may not be good.
Physical therapy can help improve strength and balance. Physical therapy can also reduce pain and swelling at the fracture site.
Your doctor will recommend that you complete physical therapy 3 times a week for 1 month.
Full recovery after a cuboid bone break can take 3 months, with the prognosis (outlook) being good.
Listed below is a sample of a physical therapy protocol for cuboid fractures:
- Soft tissue mobilization techniques: These techniques will help reduce pain and swelling. This can also promote tissue healing.
- Strengthening exercises: Exercises that focus on strengthening the muscles of the foot and leg. This generally includes balance (proprioception) training.
- Range of Motion: Gentle range of motion exercises to the ankle and subtalar joints. Progress to active and resisted range of motion exercises as tolerated.
- Gait Training: Initiate gait training using crutches or other assistive devices as needed.
Listed below are sample exercises that can be performed:
- Toe Taps: Starting in a seated position, slowly tap your toes on the floor.
- Heel Slides: Starting in a seated position, slowly slide your heel along the floor while keeping your toes pointed up.
- Ankle Pumps: Starting in a seated position, slowly pump your ankle up and down.
- Ankle Circles: Starting in a seated position, slowly rotate your ankle in a circular motion.
- Foot Raises: Starting in a seated position, slowly lift your foot off the floor and hold for a few seconds before slowly lowering it back down.
- Resistance Band Exercises: Use a resistance band to perform exercises such as ankle circles, resisted ankle dorsiflexion, resisted eversion, and resisted inversion.
- Balance Training: Use a balance board to practice balance and stability.
Cuboid Fractures That Won’t Heal
If you have a non-displaced cuboid fracture that hasn’t healed for 2-3 months, your doctor may suggest using an external bone stimulator.
This device uses electrical stimulation to encourage bone healing at the fracture site. It is a device that you wear for 20 minutes a day and can be effective in speeding up the healing process. Complications with bone healing can occur in people who smoke or have a weak immune system.
In some cases, your doctor may suggest surgery to fix the fracture and secure the fragments together using plates and screws. This can help speed up healing.
In conclusion, treating nondisplaced cuboid fractures requires a combination of immobilization, protected weight bearing, and physical therapy. Treatment should be tailored based on the fracture type and the person being treated.
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