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The cuboid bone is one of the small bones of the outer midfoot. It’s located on the outside of the foot, behind the fourth and fifth metatarsals (long bones in the foot). Because of its location, the cuboid plays an important role in balance and weight-bearing. When the cuboid becomes fractured or dislocated, it can cause pain and difficulty walking.
A cuboid fracture occurs from high-impact injuries such as falls, blows to the foot, and motor vehicle accidents. Most cuboid fractures can be treated non-surgically, however, some cuboid fractures require surgery.
This is especially true if the cuboid bone is displaced (fracture fragments have a gap and are shifted) or if there is misalignment of the joint spaces with which the cuboid articulates.
To read more about cuboid fractures in detail, check out this supplemental post: Cuboid Fractures of the Foot- A Helpful Treatment Guide.
Cuboid Fracture Surgical Procedure- What to Expect
Cuboid fracture surgery is usually performed as an outpatient procedure, which means you will be able to go home the same day.
The surgery would be performed under general anesthesia.
Your doctor will reduce and realign the fracture fragments and use screws/stapes/plates to hold the fragments in place. If there are other fractures present (which is often the case with cuboid fractures), your doctor will repair those fractures at the same time.
The skin will be closed using sutures (thread) or staples. Surgery can take anywhere from 1-3 hours to complete.
Your doctor will apply a cast or splint on your leg and you will be discharged the same day.
Cuboid Fracture Surgery Recovery- What to Expect
Recovery from cuboid fracture surgery typically involves a combination of rest, ice, compression, and elevation (RICE therapy). Make sure to elevate your leg using two pillows.
Your doctor will recommend that you stay off of the surgical foot for a minimum of 8 weeks after surgery, followed by 4 weeks of gradual weight bearing in a below-knee cast boot.
In general, fracture healing can take 6-8 weeks minimum. This may be delayed if you have comorbidities such as diabetes or have a positive smoking history. This comorbidities can delay bone healing.
Your doctor will obtain x-rays every few weeks after surgery to ensure that the bone is healing correctly. After 3 months, your doctor may allow you to transition to athletic shoes.
Your doctor will recommend you start physical therapy to help reduce pain/swelling and improve strength in the foot. Physical therapy will need to be done 3 times a week for 1 month.
Complications of Cuboid Surgery
Infection: One of the most serious complications that can occur after any type of surgery is an infection. When dealing with a surgical wound, there is always a risk of bacteria getting into the wound and causing an infection. In some cases, the hardware in the foot may become infected as well.
Symptoms of an infection include redness, swelling, and discharge from the wound site. If you experience any of these symptoms after your surgery, it is important to contact your doctor immediately.
Your doctor will recommend you start taking antibiotics and in some cases may even remove the hardware in your foot.
Nerve Damage: Another potential complication of cuboid fracture surgery is nerve damage. During the surgery, nerves in the area may be damaged. This can lead to numbness, tingling, burning, or weakness in the affected area.
In some cases, nerve damage may be temporary and will improve over time. However, in severe cases, nerve damage can be permanent.
Nonunion: In some cases, the fracture fragments may not fully heal after 3 months. This is known as a nonunion. When a bone breaks, the body forms new bone to repair the break. In some cases, the ends of the broken bone may not line up correctly or blood flow to the area may be poor. This can delay or prevent healing.
In these cases, your doctor may suggest you use a bone stimulator to heal the fracture. If that doesn’t work, surgery may be needed to resect the nonunion to help promote healing.
Blood clots: Another possible complication of cuboid fracture surgery is the formation of blood clots in the surgical limb. Due to the limb being immobilized in a cast for several weeks, the chance of developing a blood clot is higher. Increased weight and consumption of birth control pills can increase your risk for blood clots.
In some cases, your doctor may recommend you take a blood thinner like Aspirin to reduce the chances of a blood clot post-surgically.
Symptoms of a blood clot include pain, swelling, and warmth in the affected area. If you experience any of these symptoms after your operation, it is important to contact your doctor immediately. Blood clots can be life-threatening.
When Can You Drive After a Cuboid Fracture Surgery?
Your doctor will recommend that you refrain from driving for at least 6-8 weeks after surgery. You should not drive with a cast or cast boot on. You should also avoid driving while taking narcotics due to side effects.
When Can I Return to Work After Cuboid Fracture Surgery?
If you have a sit-down job, you may be able to start working 2-3 weeks after surgery. As long as you can keep your leg elevated to reduce swelling, and are not taking narcotics, you can complete your job duties. However, if you are required to stand for prolonged periods or walk at work, you may need to take 2-3 months off work.
Ask your doctor for recommendations, because return to work times vary depending on the individual.
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