Treatment of fractures of the cuboid and scaphoid bones. Midfoot fractures Cuboid dislocation

An unsuccessful fall from a height can lead to serious injuries, including fractures of bones located in the foot. Just such bones include the cuboid bone, which is localized in the area of ​​the outer part of the foot. Most often, its fracture occurs in combination with a violation of the integrity of other bones in this area. But sometimes it can be damaged on its own, for example, if something falls on your leg. So, let's clarify what to do if a fracture of the cuboid bone of the foot occurs, what should be the treatment of the bone in such a situation.

Of course, the need to treat a fracture of the cuboid bone arises only after confirmation of the diagnosis, which only a traumatologist can do. To determine the problem, an x-ray examination is necessary.

The patient himself may suspect something is wrong based on a number of symptoms.:

Disturbances in the full functioning of the foot - pain when moving and turning, inability to fully stand on the foot;

Severe painful sensations;

Puffiness and swelling;

Subcutaneous bleeding.

Over time, other symptoms may appear:

Pain in a certain area when palpated;

Leg deformities;

Specific step performances;

Increased pain in response to movement.

Treatment of the cuboid bone of the foot

As soon as an injury occurs, it is necessary to fix the knee and ankle joint. This can be done by applying a splint using any available means, for example, sticks and ropes. Fixation will help prevent the dislocation of fragments (if they have formed) and ensure a faster recovery.

If an X-ray examination shows the presence of a complex fracture - displacement or bone fragments, and also if the fracture is open, the patient is indicated for surgical intervention. Doctors normalize the position of the bone, remove fragments and, if necessary, install fixing metal pins. After this, a plaster cast is applied to the affected limb. In case of a complex fracture, you will need to wear it longer - about two to three months.

When a cuboid bone fracture occurs, the victim is usually advised to take analgesics (painkillers) until the unpleasant symptoms disappear. Sometimes doctors may also prescribe non-steroidal anti-inflammatory drugs. In some cases, it is advisable to use local medications in the form of gels or ointments, which help eliminate swelling and get rid of hematomas.

In the first week, a patient with a fracture of this kind cannot even lean slightly on the injured leg. He needs to use crutches to get around. Over time, a slight load is allowed, but only with the approval of a doctor.

Further recovery

After removing the plaster cast, the patient usually experiences discomfort, pain and other unpleasant sensations in the injured limb. This is quite easy to explain, because during the period of wearing the cast the muscles weakened and became completely incapable of exertion. Therefore, proper rehabilitation is necessary to successfully restore physical activity.

The patient needs to undergo regular kneading massages (self-massages) of the entire foot and lower leg. In this case, with the permission of a doctor, you can use warming agents or massage oils.

It is extremely important to gradually load the leg, and not immediately move on to full-fledged physical activity. First you need to do some simple exercises:

Bend and straighten the leg at the ankle joint;

Perform rotating movements with the ankle joint.

After a few days you need to move on to more complex loads:

Rise carefully on your toes and lower yourself down;

Trying to lift various objects from the floor with your foot;

Roll round objects on the floor with your feet.

The recovery program after a cuboid fracture usually includes physical therapy procedures. Thus, exposure to interference currents, ultraviolet therapy and electrophoresis with various active components have an excellent effect. UHF therapy is sometimes practiced.

Usually, for successful recovery, doctors recommend wearing shoes with special arch supports. They will contribute to proper load distribution. Typically, this recommendation remains valid for one year after the cast is removed, but for complex injuries it is better to use appropriate shoes longer. Sometimes doctors even insist on wearing orthopedic shoes made to individual measurements.

Fractures of the cuboid bone are rare. This is due to the peculiarities of the anatomical position of the cuboid bone, in which it is protected from damage by surrounding bones.

The main types of cuboid fractures are compression and avulsion fractures.

Fractures due to bone deficiency are called stress fractures and constitute the third and least common group of injuries.

The most common type of fracture of the cuboid bone is an avulsion fracture in the area of ​​its outer surface.

The tear occurs in the area of ​​attachment of the calcaneocuboid ligament, and the bone fragment, in fact, comes off along with it.

These fractures are best seen on x-rays or CT scans.

They are often missed, mistaking the injury for a simple “sprain.”

Patients describe a typical mechanism of injury in the form of twisting of the foot, often the foot turns inward.

Clinically, with such fractures, pain will be localized along the outer edge of the foot.

A thorough examination in such cases can distinguish damage to the external ligaments of the ankle joint from an avulsion fracture of the cuboid bone.

The severity of subcutaneous hemorrhages and bruises with such fractures may vary.

Conservative treatment

The vast majority of avulsion fractures can be treated conservatively, as they are mostly non-displaced or minimally displaced fractures.

Surgery

Surgery is rarely indicated for patients with cuboid avulsion fractures.

The operation is indicated primarily for patients with clinically significant pseudarthrosis after an avulsion fracture, for which adequate conservative treatment has already been carried out, including immobilization for 8-12 weeks and modification of the shoes used.

In such cases, it is usually sufficient to remove the unfused fragment of the cuboid bone.

The second most common type of scaphoid fracture is compression fractures.

This type of fracture occurs as a result of a relatively higher-energy injury, most often from a fall on the foot.

These fractures are also often associated with Lisfranc injuries or other tarsometatarsal joint fractures/dislocations, requiring special attention.

Patients typically report a history of high-energy trauma.

Soon after such an injury, severe swelling of the foot most often develops. Patients with such a foot injury are usually examined very carefully, since fractures of the cuboid bone are often combined with fractures or dislocations in other parts of the foot.

All patients undergoing a high-energy injury that results in a cuboid fracture undergo a CT scan, since concomitant injuries to the tarsal and metatarsal bones are also common in these patients.

Conservative treatment

For patients with isolated non-displaced or minimally displaced cuboid fractures, immobilization with a short plaster splint that allows weight-bearing is indicated.

Upon termination of immobilization, the plaster splint is replaced with an orthopedic boot and dosed loads on the foot are allowed.

Return to regular shoes is determined by the severity of pain and residual swelling, and the presence of radiological signs of fusion.

Most often, patients begin wearing their usual shoes 8-12 weeks after the injury.

Surgery

The management of displaced cuboid fractures is still a matter of debate, as there is no consensus on how significant the displacement must be for the fracture to be definitively treated surgically.

Most doctors agree that the cuboid bone is an important stabilizer of the lateral column (outer edge) of the foot, and changes in the length of the lateral column inevitably lead to the development of foot deformities, flat feet and pain.

The most common deformity due to a compression fracture of the cuboid is shortening of the lateral column, so any surgical intervention should be aimed at restoring this length of the lateral column.

There are various surgical techniques. In our practice, we restore the length of the lateral column through internal fixation of the fracture with plates and screws and, if necessary, bone grafting using supporting autografts from the iliac crest.

The results of treatment in all patients were good, and we use this method of treatment for any fractures of the cuboid bone accompanied by compression of its articular surface.

In case of comminuted fractures, the only way to restore the length of the lateral column of the foot may be bridging osteosynthesis with a plate. If the fracture is accompanied by severe soft tissue damage, the only treatment option may be an external fixator. Regardless of the fixation technique used, all attention should be focused on maintaining the length of the lateral column of the foot, without which it is impossible to restore the normal shape and function of the foot.

Bone deficiency fractures, or stress fractures of the cuboid, are usually characterized by the gradual development of pain in the area of ​​the outer edge of the foot, which is aggravated by physical activity.

These fractures are rare and often remain undiagnosed.

Advanced radioimaging techniques are often necessary for diagnosis.

Cuboid stress fractures are common in athletes.

Conservative treatment

Conservative treatment in most cases allows for consolidation of a stress fracture of the cuboid bone.

Initially, the patient may be immobilized for 4-6 weeks.

In the absence of load, this period is sufficient for the fracture to heal.

Once immobilization is complete, the degree of weight bearing on the leg and level of physical activity will be determined by the patient's symptoms.

Surgery

Surgical treatment for these fractures is rarely indicated. It can be indicated, for example, when the patient, despite adequate conservative treatment, continues to have pain.

Before making a final decision on surgical treatment, we prescribe our patients a course of high-energy shock wave therapy.

Surgical treatment may include bone grafting of the fracture area and stabilization with a compression screw. If this is also ineffective, arthrodesis of the calcaneocuboid joint may be indicated.

A foot fracture is one of the most common types of fracture.

The huge number of bones in the foot, the enormous loads that these bones must withstand every day, and the lack of minimal knowledge about the prevention of foot fractures make this complex anatomical formation especially vulnerable.

Anatomical excursion

The foot is the lower part of the lower limb, which has an arched structure and is designed to absorb impacts that occur when walking, jumping and falling.

The feet perform two main functions:

• firstly, they maintain body weight;
• secondly, they ensure the movement of the body in space.

These functions determine the structural features of the feet: 26 bones in each foot (a quarter of all bones in the human body are located in the feet), joints connecting these bones, a large number of powerful ligaments, muscles, blood vessels and nerves.

The joints are inactive, and the ligaments are elastic and highly durable, so a dislocation of the foot occurs much less frequently than a fracture.

Since we're talking about fractures, let's pay special attention to the bony skeleton of the foot, which consists of the following bones:

1. Heel. This is the largest bone of the foot. It has the shape of a complex three-dimensional rectangle with depressions and protrusions to which muscles are attached and through which nerves, vessels and tendons pass.
2. Talus (supraheel). It is in second place in size, unique in its high percentage of articular surface and in that it does not contain a single bone or tendon attachment. It consists of a head, a body and a neck connecting them, which is the least resistant to fractures.
3. Cuboid. It is located in front of the heel bone, closer to the outside of the foot. Forms the arch of the foot and forms a groove, thanks to which the peroneus longus tendon can fully work.
4. Scaphoid. Forms joints with the talus and three sphenoid bones. Rarely, the development of this bone is disrupted and the 27th bone of the foot, an accessory navicular bone connected to the main cartilage, may be observed. When an unskilled X-ray is read, an accessory bone is often mistaken for a fracture.
5. Wedge-shaped. Attached to other bones on all sides.
6. Metatarsals. Short tubular bones serve for shock absorption.
7. Phalanges of the fingers. They are similar to the phalanges of the fingers in number and location (two flanks for the thumbs and three for each other finger), but shorter and thicker.
8. Sesamoids. Two very small (less than a pea) but extremely significant round bones are located inside the tendons and are responsible for the flexion of the first toe, which bears the maximum load.

Every tenth fracture and every third closed fracture occurs in the foot (for military personnel this figure is slightly higher and amounts to 13.8% in peacetime).

The most common foot fractures are:

• talus - less than 1%, of which about 30% of cases lead to disability;
• heel - 4%, of which 83% - as a result of jumping on straight legs from a great height;
• cuboid - 2.5%;
• scaphoid - 2.3%;
• Metatarsal is the most common type of foot bone injury.

Moreover, for athletes, a fracture of the fifth metatarsal bone is typical under excessive loads, and for people experiencing unusual excessive loads, often in uncomfortable shoes, a fracture of the second, sometimes 3 or 4, and rarely 1 or 5.

The average duration of disability for a toe injury is 19 days. This type of injury is not typical for children; incomplete fractures (cracks) occur.

At a young age, split fractures are common, after 50 years - depressed.

Causes of injury

A fracture of the foot bones can occur for several reasons:

• heavy objects falling on the foot;
• jump (fall) from a great height and land on your feet;
• when kicked;
• when hit on the leg;
• with subluxation of the foot due to walking on uneven surfaces.

Features of fractures of different bones

There are different types of fractures depending on the bone that was injured.

Calcaneal fracture

The main cause of occurrence is landing on the heels when jumping from a significant height, the second most common is a strong blow during an accident. Upon impact, the weight of the body is transferred to the talus, it crashes into the heel and splits it into pieces.

Fractures are usually unilateral and usually complex.

A special feature is the stress fracture of the calcaneus, the main cause of which is chronic overload of the bone, which has anatomical defects.

It should be noted that the mere fact of the presence of an anatomical defect does not lead to a fracture; constant and fairly serious loads are required for its occurrence, therefore, most often such a fracture is observed in army recruits and amateur athletes who neglect a medical examination before prescribing high loads.

Trauma to the talus

A relatively rare fracture that occurs as a result of a fall from a great height, an accident, or impacts and is often combined with injuries to the lumbar spine and other fractures (of the bones of the foot, the heel usually suffers along with the talus).

The injury is considered severe and leads to disability in a third of cases. This state of affairs is associated with a lack of blood circulation provoked by injury.

Even if the vessels are not ruptured, due to their compression, the supply of nutrients to the bone is disrupted, and the fracture takes a very long time to heal.

Cuboid fracture

The main cause of a fracture is a heavy object falling on the leg; a fracture due to an impact is also possible.

As is clear from the mechanism of occurrence, it is usually one-sided.

Scaphoid fracture

It is formed as a result of a heavy object falling on the back of the foot at a time when the bone is under tension. A fracture with displacement and in combination with fractures of other bones of the foot is typical.

Recently, stress fractures of the scaphoid bone have been observed, which was previously very rare - this is primarily due to the increase in the number of non-professional athletes who train without medical and coaching support.

Damage to the sphenoid bone

The consequence of a heavy object falling on the dorsum of the foot and crushing the wedge-shaped bones between the metatarsals and naviculars.

This mechanism of occurrence leads to the fact that fractures are usually multiple, often combined with dislocations of the metatarsal bones.

Metatarsal fractures

The most commonly diagnosed are divided into traumatic (arising as a result of a direct blow or twisting

feet) and fatigue (occur due to foot deformation, prolonged repeated loads, improperly selected shoes, osteoporosis, pathological bone structure).

A stress fracture is often incomplete (it does not go beyond a crack in the bone).

Trauma to the phalanges of the fingers

A fairly common fracture, usually caused by direct trauma.

The phalanges of the fingers lack protection from external influences, especially the distal phalanges of the first and second fingers, which protrude noticeably forward compared to the rest.

Almost the entire spectrum of fractures can be observed: transverse, oblique, T-shaped, and comminuted fractures are found. Displacement, if observed, is usually on the proximal phalanx of the thumb.

In addition to displacement, it is complicated by the penetration of infection through the damaged nail bed, and therefore requires sanitary treatment of the fracture site even if the fracture at first glance seems closed.

Sesamoid fracture

A relatively rare type of fracture. The bones are small, located at the end of the metatarsal bone of the big toe, and are usually broken due to sports activities associated with heavy load on the heel (basketball, tennis, long walking).

Sometimes it is easier to remove the sesamoids than to treat the fracture.

Symptoms depending on location

Symptoms of foot fractures, regardless of type:

• pain,
• edema,
• inability to walk,
• bruising in the area of ​​injury,
• change in the shape of the foot due to a displaced fracture.

Not all symptoms may be present, and the severity of the symptoms depends on the specific injury.

Specific signs:

In the photo, a characteristic symptom of a foot fracture is swelling and cyanosis.

• with an talus fracture: displacement of the talus (noticeable on palpation), pain when trying to move the thumb, sharp pain in the ankle when moving, the foot is in a flexed position;
• with cuboid and navicular fractures: acute pain in the location of the corresponding bone, when trying to abduct or adduct the forefoot, swelling on the entire anterior surface of the ankle joint.

Diagnostic methods

Diagnosis usually comes down to an X-ray examination, which is carried out in one or two projections, depending on the location of the suspected fracture.

If a talus fracture is suspected, an X-ray examination is uninformative; the optimal diagnostic method is computed tomography.

First aid

The only type of first aid for suspected foot fractures is to keep the foot immobilized. This is carried out in mild cases by prohibiting movement, in other cases by applying a splint.

The victim should then be taken to the clinic. If swelling occurs, cold can be applied.

Therapeutic measures

Treatment is prescribed depending on several factors:

• type of broken bone;
• closed or open fracture;
• complete or incomplete (crack).

Treatment consists of applying a plaster splint, plaster cast, bandage or fixator, surgical or conservative treatment, including physical therapy and special massage.

Surgical treatment is performed in exceptional cases - for example, for displaced fractures of the sphenoid bones (in this case, surgery with transarticular fixation with a metal Kirschner wire is indicated) or for fractures of the sesamoid bones.

Recovery after injury

Recovery from injury is achieved through special massage and exercise therapy, reducing the load on the affected limb, using orthopedic insoles, arch supports, heel pads and avoiding wearing heels for a long period.

With fractures of the sphenoid bones, prolonged pain may occur.

Complications

Complications are rare, with the exception of extremely rare fractures of the talus.

Foot fractures are not life-threatening. However, the quality of later life largely depends on whether the injured person received treatment.

That is why it is important, if symptoms of injury occur, not to self-medicate, but to seek qualified medical help.

In addition, I would like to draw the attention of non-professional athletes and physical educators to the fact that thoughtlessly increasing loads and using inappropriate shoes during exercise is a direct way to close the opportunity to engage in physical education forever.

Even a high-quality recovery from a foot injury will never allow you to return to super-intense training. Prevention is always easier than cure.

Causes of sharp and nagging pain in the foot when walking, in the morning and constant

Pain on the outside of the foot is caused by a number of reasons. It can be on the inside (medial) and on the outside (lateral), in the arch, instep, in the upper part and on the soles, sharp and, on the contrary, aching.

Depending on how and under what circumstances the pain syndrome arose, gradually over time or abruptly after an injury, and also taking into account specific symptoms, it will be easier to figure out what is causing it.

Let's look at the most common causes of severe pain on the outside of the foot. We will dwell on the general causes of each condition, how they manifest themselves, their classic signs and symptoms. At the end of the article there is a simple diagnostic guide. Read on to learn more about the most effective treatment options for each individual case.

Common Causes

1) Stress fractures

Stress fractures are a common cause of the problem in question. These are small cracks in one of the bones, usually caused by monotonous, repetitive movements while participating in sports activities.

Which areas are most affected? The location of the pain depends on what exactly is damaged. Fractures of the calcaneus or navicular cause pain on the side of the foot, while stress fractures of the metatarsal bones cause pain on either side of the foot.

In this case, it usually does not hurt much at first, it drags, but gradually the condition worsens.

2) Ankle sprain

Ankle sprains are the most common cause of severe pain on the outside of the foot (from ankle injuries). Its share accounts for up to 85%. This happens to the ankle during inversion.

Any ligament can be stretched, but the anterior talofibular ligament is most often affected. It gets damaged when we turn our leg inward. The ankle appears to be displaced outward. This is known as an inversion injury. It causes some or all of the fibers of the ligament to tear, causing severe pain, swelling, bruising, and instability of the joint.

35% of people who have an ankle sprain go on to have ongoing problems with pain and instability. This also contributes to future sprains. The problem can be avoided through careful rehabilitation after the first injury.

3) Cuboid syndrome

Cuboid syndrome (see picture) is a less common cause of lateral foot pain, but is often diagnosed to result in symptoms that are present for a long time.

This occurs when one of the small bones in the foot becomes partially dislocated after an injury such as a sprained ankle or as a result of chronic overuse of the leg.

The most common symptom is external pain that extends down to the toes. It begins to hurt more severely in the morning, when walking and running, especially on uneven surfaces and when jumping. There is redness and swelling. If symptoms are accurately diagnosed and treated right away, they usually resolve within a few weeks.

If the foot remains unimpaired for more than 3 months, the next thing to suspect after the ankle is cuboid syndrome, which occurs in almost 7% of people with an ankle sprain.

4) Peroneal tendonitis

Peroneal tendonitis is another common cause of pain on the outside of the foot and in the heel area. The disease occurs when the peroneal tendon of the foot is repeatedly overstrained, causing it to become irritated, inflamed, and degenerate.

It is usually caused by frequent walking long distances, abnormal foot alignment, muscle imbalances and occurs after an ankle sprain. With tendonitis, the condition worsens gradually over several weeks or months and the foot hurts especially severely when taking the first steps in the morning, as well as when starting activity after resting.

5) Tarsal coalition

Tarsal coalition is one of the rarest causes of leg pain, occurring in approximately 1 in 100 patients.

The condition is caused by 2 or more bones fused together. This is a congenital problem and symptoms usually appear in the second decade of life.

They often come very unexpectedly, such as pain, fatigue and cramps. It can also affect you in such a way that you walk abnormally. There are other problems such as ankle sprains and abnormal foot biomechanics. Treatment usually includes surgery, shoe inserts, and foot immobilization.

6) Bunyon

Bunions are a common cause of bunion deformity and pain in the big toe.

They develop when the thumb is turned inward, pointing towards the others. This causes the bones at the base of the big toe to protrude. The result is pain, inflammation, redness and swelling around it. The medical term for bunion is hallux valgus. Sometimes this problem happens with the little finger.

There is believed to be a genetic link to bursitis. It especially affects those whose joints are overly flexible, but it can also be due to bad shoes, in which the toes are squeezed inward. Diseases such as gout and rheumatoid arthritis increase the risk. In cases of moderate severity, special devices that straighten the fingers are helpful, but in more severe cases, surgery may be required.

7) Calluses

Calluses appear on any part of the leg, often on the back, top and sides. They form when an area of ​​skin is subjected to repeated friction and it tries to protect itself by creating additional layers.

Calluses are usually painless, but deep ones are very unpleasant. There are simple rules for their treatment and prevention.

8) Posterior tibialis tendonitis

Tibialis posterior tendonitis causes pain on the inside of the foot.

The tendon is connected to the inside of the ankle. Its main function is to support the inner arch of the foot. Like all other types of tendinitis, this one develops when the tendon becomes irritated, inflamed, or deteriorated, usually due to chronic overuse or injury.

The pain intensifies with activity and subsides when the legs are given rest. Those suffering from tendonitis often have flat feet.

9) Arthritis

Arthritis can cause pain anywhere on the lower limb, but in most cases it occurs on the instep and side. There are 2 common types of arthritis - rheumatoid (inflammatory) and osteoarthritis (degenerative). More often the leg hurts due to rheumatoid arthritis. Symptoms of varying severity come and go and occur in attacks.

How to diagnose your condition

As you can see, there are a number of different causes of the disease in question. If the problem is related to injury, then most likely it is a sprained ligament or cuboid syndrome; if the pain came gradually, it could be a stress fracture or tendinitis. In adolescents, this is most likely due to the tarsal coalition. In people over the age of 50, arthritis is more likely to be the case. If the skin feels dry and thickened, there is a callus or callus tissue.

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Cuboid fracture

The cuboid bone is located in the area of ​​the outer part of the foot, but despite this, its isolated fractures are quite rare.

Among foot bone fractures, cuboid bone fractures account for about 2.5%, and among skeletal bone fractures - 0.14%.

The cuboid bone (tal. os cuboideum) refers to the bones of the tarsus of the foot.

Its articular surfaces (formed by cartilage) articulate with the fourth and fifth metatarsals and the calcaneus.

The cuboid bone is located at the outer edge of the foot between the heel bone and the metatarsal bones.

Causes and mechanisms

Fractures of the cuboid bone occur as a result of direct trauma, such as a blow and a heavy object falling on the foot.

Symptoms

Symptoms common to fractures come to the fore: pain, dysfunction, pain intensifies with passive movements, swelling, hemorrhage.

But upon careful examination, symptoms are revealed that characterize the unconditional presence of a fracture of the cuboid bone: acute pain on palpation corresponds to the location of the cuboid bone, the presence of deformation of its contours, stepwise protrusions when fragments are displaced, exacerbation of pain when axial pressure is applied to the IV-V metatarsal bones, when trying to abduct or adduct the forefoot during rotational movements.

In cases where a fracture of the cuboid bone occurs simultaneously with a fracture of the scaphoid with subluxation of the bones, a deformity occurs, which depends on the degree of displacement of the fragments with flattening of the arch with deviation of the forefoot outward or inward.

During palpation, pain aggravates when touching all the bones of the area, with axial pressure on all toes.

Fractures with displacement, subluxation or dislocation of fragments disrupt the contours of the bones along the dorsal surface with the presence of a stepped deformity.

Diagnostics

The final diagnosis is made after an x-ray examination.

But it should be remembered that there are additional bones: the fibular epiphysis of the tuberosity of the V metatarsal bone (described by V. Gruber in 1885) - located in the angle between the cuboid and V metatarsal bones, closer to its posterior surface.

Os regoneum - appears under the tuberosity of the cuboid bone, at the junction of the cuboid and calcaneus and can consist of two parts - os cuboideum secundarium in the form of a process of the cuboid bone, which goes towards the scaphoid bone os cuboideum secundarium - a bone that is located between the heel, talus , cuboid and scaphoid bones.

On radiographs, all additional bones have clear surfaces and edges, whereas in fractures, the fracture planes are uneven and jagged. In addition, they are painful on palpation and there is no hemorrhage.

First aid

First aid for a fracture of the cuboid bone corresponds to the actions provided to the victim for fractures of other bones of the tarsus and metatarsus.

It is necessary to fix the ankle and knee joints to prevent displacement of the fragments. For this, you can use any available means (boards, sticks, iron rods, towels, scarves, any other fabrics).

As a last resort, you can bandage the injured leg to the healthy one.

Treatment

Typically, fractures of the cuboid bone are not accompanied by serious displacement of the fragments, as is the case with fractures of the sphenoid bones.

Therefore, treatment comes down to immobilization with a “boot”-type plaster cast, with a metal instep support built into the plantar part.

A plaster cast is applied from the fingertips to the middle third of the shin for a period of 6 weeks. It is important to correctly model the arch of the foot.

Rehabilitation

In the first week after the injury, walking is prohibited, then a dosed load on the injured leg is allowed.

After the immobilization is removed, the patient is prescribed physiotherapeutic treatment, mechanotherapy to develop the ankle joint, and physical therapy. Working ability returns after approximately 8–10 weeks.

Why does my foot hurt when walking?

After every kilometer walked, the legs experience a load weighing 60 tons. Although the limbs can withstand a lot, they are also susceptible to stress and disease.

Forefoot diseases

The front third of the foot consists of the metatarsal bones, phalanges and ligaments between them. Calluses, blisters, mycoses, hammertoes, Morton's neuroma, hallux valgus, gout - various conditions are associated with the pathology of these elements of the foot. Metatarsalgia is any pain whose cause is unknown. Traumatic injuries or shoes that are too narrow increase the likelihood of foot pain when walking.

Movement is extremely healthy, but pain that interferes with every step is a serious cause for concern.

Extensor tendonitis of the foot develops due to constant overstrain of the lower leg - long walking in uncomfortable shoes can be the main cause. The pain intensifies when trying to bend or straighten the fingers.

Stress fractures threaten people who are overweight, which puts increased stress on the bones. Even experienced marathon and running athletes can suffer from recurring bouts of pain. They intensify while walking and do not stop over time.

Midfoot Diseases

The middle third of the foot is represented by the tarsal bones and their joints. They account for a significant part of the medial longitudinal arch of the arch of the foot. Midfoot pain when walking occurs as a result of stress fractures, lateral plantar nerve entrapment, equine deformity (associated with too high an arch), tibial posterior tendon sprains, tibial nerve syndrome, and extensor tendinitis. Treatment directly depends on the diagnosis, which is best not to delay, as cascading pain can worsen.

Fractures of the second, third and fourth metatarsals are common in people who engage in morning jogging. Gradually, you feel that your foot hurts when walking. The pain rises upward, accompanied by swelling.

The navicular bone runs along the inside of the middle of the foot and is more complex to fracture. Initially, the pain only occurs during exercise and goes away after rest, but over time, recovery periods become longer.

Fracture-dislocations in the Lisfranc joint, formed by an accumulation of small bones in the arch area, are caused by the anatomy of the first and second metatarsals, which do not have ligaments. This leads to dislocations during sharp turns or jumps.

Microtears of the thick plantar fascia often affect the heel area, but women's feet, whose joints are unstable, suffer from painful attacks after getting up in the morning. Medicines and physiotherapy come to the aid of patients.

If your foot hurts when walking, you cannot exclude the influence of shoes, especially for people who play sports, are pregnant, or suffer from arthritis. A sole that is too soft sag and does not support the foot, causing discomfort after any walk.

Rear foot diseases

The back third of the foot consists of the calcaneus and talus, and the joints connecting them to each other. The answer to the question of why your heel hurts lies in the anatomy of the foot. When walking, the heel is the first to hit the ground, and enormous forces are exerted on its tissues. Pain in this area is the most common complaint in adults. Inappropriate shoes and injuries top the list of causes that relate to this symptom. Plantar fasciitis, heel contusions, stress fractures, tarsal tunnel syndrome, medial calcaneal nerve entrapment, Achilles tendon bursitis, and calluses all affect the heels, with the left foot being more commonly affected than the right.

How to restore lightness of gait?

Any disease is easier to prevent, since irreversible processes require expensive and lengthy treatment. Care is the main condition for beautiful and healthy feet. You cannot walk for a long time in shoes with a narrow toe and high heels. It is advisable to use special orthopedic insoles prescribed by an orthopedist.

Try to bring your excess weight back to normal and include foods with calcium in your diet to strengthen your bones. If possible, it is better to avoid standing for long periods of time and do not sit with one leg crossed over the other, as this impairs blood circulation. Sports and other physical activities should be reasonable, and training shoes should have high-quality arch supports.

After a hard day at work, your feet need a decent rest. Treatments include relaxing baths with sea salt and essential oils, as well as light massages.

It is better to solve problems with the legs with an orthopedist who develops a full cycle of gymnastics for every day. Even the usual “bicycle” exercise, stretching your feet in different directions, away from you and towards you with a towel, reduces the load on the arch. If you raise your legs up and just shake them thoroughly, you can get rid of swelling and normalize blood flow. Take care of your foot health!

Are there lateral spurs on the feet?

Vladimir Priorov

Typically, a heel spur causes pain when you step on your foot, that is, from the bottom of the heel.

MuDaKoV.net Alexey

Certainly))))))

Alena Khazova

Fractures of the bones of the foot often account for a tenth of all fractures. The cause of their occurrence is not only direct injuries, but also unsuccessful landings on the foot, its twisting, and various falls.

For fractures of the navicular or cuboid bones of the foot, complex treatment and an appropriate period of rehabilitation are recommended, since a change in the shape of any of them can lead to a disruption in the shape of the entire foot and its basic functions.

Bone Anatomy

There are about 26 bones in the foot, connected to each other by the ligamentous-articular apparatus. It is customary to distinguish the following main departments:

• metatarsal;
• tarsal;
• phalanges of fingers.

The sphenoid bone and navicular bone are located in the tarsal region, forming this section together with the calcaneus, talus and three wedge-shaped bones.

The navicular bone is located closer to the inner edge of the foot. At the back it connects with the talus bone, and at the front with the three sphenoid bones. There is a concavity on its lower surface, and on the outside there is a characteristic tuberosity that can be easily felt through the skin.

The cuboid bone gets its name from its irregular cube shape. It has a connection with the navicular bone, one of the sphenoid bones, the calcaneus and metatarsal bones (fourth and fifth). There is a noticeable groove and irregularities on the surface.

The navicular and cuboid bones bear the supporting load when walking, taking a direct part in it. A fracture of any of them entails a loss of motor activity, which can persist for a long period of time, especially with incorrect treatment tactics. It is important to seek prompt medical attention for any injuries.

Scaphoid fracture

Among all the causes of scaphoid fractures, the main one is the fall of heavy objects on the outer surface of the foot.

Professional athletes suffer from such fractures due to intense contractions of the tibialis muscle during exercise. This leads to the separation of the bone fragment that is attached to this muscle.

Other reasons include:

• injuries arising from forced intense flexion of the plantar part of the foot, resulting in pinching of the navicular bone between the sphenoid bones and the talus;
• Road accident - the cause of the fracture is compression;
• unsuccessful landing after jumping or falling from a height;
• stress fractures - occur among ballet dancers, professional athletes and gymnasts due to prolonged high loads on the foot, entailing restructuring of bone structures.

As a result of the injury, fractures of the scaphoid bone in the area of ​​its dorsal part, body or tubercle are possible. Often bone fragments are displaced to the back of the foot.

The following symptoms are typical:

• the occurrence of pain and swelling in the area of ​​the suspected fracture, often extending to the ankle joint;
• bone fragments are well palpated under the skin (if displaced);
• the support function suffers, the victim can only lean on the heel;
• movement of the foot up and down and left and right is impossible.

X-ray examination helps to establish an accurate diagnosis, after which appropriate treatment is prescribed.

Important! It is necessary to differentiate tubercle avulsion from the presence of a congenital additional scaphoid bone, which occurs in some people and is not considered a pathology. In this situation, x-rays of both feet are needed because accessory structures are usually found on both sides.

Cuboid fracture

The cuboid bone is not prone to fractures. This usually happens when there is a joint fracture with other bones of the foot due to heavy objects falling on the foot, an unsuccessful landing, or a fall on the feet from a height.

Typical symptoms include:

• pain that gets worse when you try to move your foot;
• swelling on the dorsal inner surface of the foot;
• inability to fully lean on the foot;
• palpation reveals a characteristic deformation (indicating displacement of bone fragments).

X-rays are crucial in making an accurate diagnosis.

Important! Fractures of the cuboid or scaphoid often damage the surrounding soft tissue. To identify all damage, in some cases, computer or magnetic resonance imaging is prescribed.

Treatment options

When fractures of the scaphoid or cuboid bones are not accompanied by displacement of fragments, a traumatologist applies a plaster cast (circular).

Modeling of the lower arch of the foot is necessary. When a bandage in the form of a “boot” is applied, a metal instep support is additionally installed, which is necessary to prevent flattening of the arch of the lower limb.

When bone fragments are displaced, reposition is required under intraosseous anesthesia or intravenous anesthesia. Dislocation and fracture of the scaphoid requires the installation of a special Circassian design, when one wire is passed through the heel bone, and the other passes through the metatarsal bones (their heads).

In severe cases, surgical treatment is performed, after which it is necessary to wear a plaster cast for at least a month. To monitor the dynamics, X-rays are taken. It is necessary to understand that all the bone structures in the foot are interconnected, so it is necessary to completely restore the fracture site.

Important! In the case of comminuted fractures, sometimes it is not possible to completely collect and fix all the fragments, which entails the need for partial removal of the bone and subsequent filling with a bone graft. This can be done by a section of the tibia or artificial materials.

Possible complications

Failure to promptly contact a medical facility or failure to comply with all the instructions of the treating doctor in case of a fracture of the cuboid or scaphoid often leads to complications.

• appearance of lameness;
• presence of chronic pain syndrome;
• the occurrence of flat feet or flattening of the sole;
• manifestations of valgus curvature of the forefoot;
• loss of ability to work.

With surgical treatment, the consequence may be shortening of the foot, and in the most severe cases, disability is often given.

To prevent the development of these complications, it is necessary to follow all the recommendations of an orthopedic traumatologist and undergo a full course of rehabilitation measures.

Rehabilitation

After applying a plaster cast for fractures of the cuboid or scaphoid bones, it is recommended to rest the leg for a week, after which you can proceed to rehabilitation. Loads in the presence of multiple fractures are possible only after a month and a half.

Important! The main goal of all rehabilitation measures is to restore the anatomical integrity of the bones of the foot and normalize its spring functions. This is necessary to soften repulsion and protect internal organs from various sharp shocks during walking and shocks when jumping or running.

Rehabilitation includes several activities.

Massage

Necessary for restoring adequate blood supply, tissue nutrition and preventing the development of muscle atrophy. It is performed at the earliest stages, before the plaster is removed from the leg. Helps relieve swelling and pain.

It is important to massage not only the injured limb (around and under the plaster cast), but also the healthy one, since the load on it increases.

After removing the cast, massage helps restore mobility to the leg, eliminate residual signs of atrophy, and restore muscle tone and elasticity.

Transverse and longitudinal stroking, rubbing and vibration are performed. All massage movements alternate with regular stroking.

Physiotherapy

Performed in conjunction with massage, it helps relieve pain and swelling. The most commonly prescribed procedures are magnetic therapy, electrical stimulation, interference currents, electrophoresis and UHF.

Physical exercises while wearing a cast are necessary to improve blood circulation; exercise increases the tone of the whole body.

During this period, simple flexion and extension with the fingers, movements in the area of ​​the hip and knee joints, and pressure on the surface of the sole with the help of a support or the hands of an assistant are sufficient. Contractions of the muscles of the sole and walking with the help of crutches will be useful.

The second stage of exercise therapy is the restoration of mobility in the joints. It is necessary to restore the supporting and spring functions of the foot and strengthen the muscle frame. To do this, you need to perform exercises to flex the sole and extend it, grab medicine balls and small objects with your feet and fingers, and work on exercise machines. The main goal of all exercises is to restore full walking.

Pool

It is useful to use different types of walking in water and a variety of exercises. A good effect was noticed after swimming with fins. All of the above exercises are allowed only after the cast is removed.

Proper nutrition

Consumption of foods high in calcium and vitamin D is beneficial. Fermented milk products, milk and seafood should be included in the diet. Vitamin and mineral complexes are recommended.

The final stage of all these measures is the complete restoration of the biomechanics of walking. We need to relearn how to jump and run. Strengthening the endurance of the muscles of the lower limb plays a huge role. Bouncing, jumping and running exercises will be useful.

Important! All exercises during the recovery period must be performed under the supervision of specialists and with their help. If pain or muscle spasm occurs, you should stop immediately and stop exercising. The injured leg should be loaded gradually.

Additional events

In addition to all of the above rehabilitation measures, after discharge from the hospital it will be useful to undergo sanatorium-resort treatment, continue to eat properly, take walks and exercise regularly.

• flexion and extension of toes;
• standing on tiptoes and then lowering onto your heels;
• turns the foot to the right and left;
• rolling a ball on the floor.

It is useful to pick up pencils and pens from the floor with your fingers or alternately stretch your foot away from you and towards you.

Long-term wearing of an instep support, orthopedic shoes, special insoles or orthosis is mandatory. A conclusion about complete recovery is given by a traumatologist or orthopedist.

Conclusion

Fractures of the bones of the foot are always a difficult ordeal, as they lead to impaired motor activity and interfere with daily activities.

Injuries require quite a long therapy and an equally long recovery period. You should always be careful and try to avoid situations that could lead to a fracture. The human body is a fragile thing, so you need to take care of it.

Fractures of the cuboid bone are rare. This is due to the peculiarities of the anatomical position of the cuboid bone, in which it is protected from damage by surrounding bones.

The main types of cuboid fractures are compression and avulsion fractures.

Fractures due to bone deficiency are called stress fractures and constitute the third and least common group of injuries.

The most common type of fracture of the cuboid bone is an avulsion fracture in the area of ​​its outer surface.

The tear occurs in the area of ​​attachment of the calcaneocuboid ligament, and the bone fragment, in fact, comes off along with it.

These fractures are best seen on x-rays or CT scans.

They are often missed, mistaking the injury for a simple “sprain.”

Patients describe a typical mechanism of injury in the form of twisting of the foot, often the foot turns inward.

Clinically, with such fractures, pain will be localized along the outer edge of the foot.

A thorough examination in such cases can distinguish damage to the external ligaments of the ankle joint from an avulsion fracture of the cuboid bone.

The severity of subcutaneous hemorrhages and bruises with such fractures may vary.

Conservative treatment

The vast majority of avulsion fractures can be treated conservatively, as they are mostly non-displaced or minimally displaced fractures.

Surgery

Surgery is rarely indicated for patients with cuboid avulsion fractures.

The operation is indicated primarily for patients with clinically significant pseudarthrosis after an avulsion fracture, for which adequate conservative treatment has already been carried out, including immobilization for 8-12 weeks and modification of the shoes used.

In such cases, it is usually sufficient to remove the unfused fragment of the cuboid bone.

The second most common type of scaphoid fracture is compression fractures.

This type of fracture occurs as a result of a relatively higher-energy injury, most often from a fall on the foot.

These fractures are also often associated with Lisfranc injuries or other tarsometatarsal joint fractures/dislocations, requiring special attention.

Patients typically report a history of high-energy trauma.

Soon after such an injury, severe swelling of the foot most often develops. Patients with such a foot injury are usually examined very carefully, since fractures of the cuboid bone are often combined with fractures or dislocations in other parts of the foot.

All patients undergoing a high-energy injury that results in a cuboid fracture undergo a CT scan, since concomitant injuries to the tarsal and metatarsal bones are also common in these patients.

Conservative treatment

For patients with isolated non-displaced or minimally displaced cuboid fractures, immobilization with a short plaster splint that allows weight-bearing is indicated.

Upon termination of immobilization, the plaster splint is replaced with an orthopedic boot and dosed loads on the foot are allowed.

Return to regular shoes is determined by the severity of pain and residual swelling, and the presence of radiological signs of fusion.

Most often, patients begin wearing their usual shoes 8-12 weeks after the injury.

Surgery

The management of displaced cuboid fractures is still a matter of debate, as there is no consensus on how significant the displacement must be for the fracture to be definitively treated surgically.

Most doctors agree that the cuboid bone is an important stabilizer of the lateral column (outer edge) of the foot, and changes in the length of the lateral column inevitably lead to the development of foot deformities, flat feet and pain.

The most common deformity due to a compression fracture of the cuboid is shortening of the lateral column, so any surgical intervention should be aimed at restoring this length of the lateral column.

There are various surgical techniques. In our practice, we restore the length of the lateral column through internal fixation of the fracture with plates and screws and, if necessary, bone grafting using supporting autografts from the iliac crest.

The results of treatment in all patients were good, and we use this method of treatment for any fractures of the cuboid bone accompanied by compression of its articular surface.

In case of comminuted fractures, the only way to restore the length of the lateral column of the foot may be bridging osteosynthesis with a plate. If the fracture is accompanied by severe soft tissue damage, the only treatment option may be an external fixator. Regardless of the fixation technique used, all attention should be focused on maintaining the length of the lateral column of the foot, without which it is impossible to restore the normal shape and function of the foot.

Bone deficiency fractures, or stress fractures of the cuboid, are usually characterized by the gradual development of pain in the area of ​​the outer edge of the foot, which is aggravated by physical activity.

These fractures are rare and often remain undiagnosed.

Advanced radioimaging techniques are often necessary for diagnosis.

Cuboid stress fractures are common in athletes.

Conservative treatment

Conservative treatment in most cases allows for consolidation of a stress fracture of the cuboid bone.

Initially, the patient may be immobilized for 4-6 weeks.

In the absence of load, this period is sufficient for the fracture to heal.

Once immobilization is complete, the degree of weight bearing on the leg and level of physical activity will be determined by the patient's symptoms.

Surgery

Surgical treatment for these fractures is rarely indicated. It can be indicated, for example, when the patient, despite adequate conservative treatment, continues to have pain.

Before making a final decision on surgical treatment, we prescribe our patients a course of high-energy shock wave therapy.

Surgical treatment may include bone grafting of the fracture area and stabilization with a compression screw. If this is also ineffective, arthrodesis of the calcaneocuboid joint may be indicated.

Video about our traumatology and orthopedics clinic

Fracture of the cuboid bone of the foot is quite common. Often, when the back of the foot is hit with a heavy object, a person does not experience much concern, in addition to pain and swelling. However, a strong blow is one of the main reasons for the formation of bone fractures in the leg. Therefore, it is very important to seek help from a specialist as soon as possible, because treatment must be carried out by a doctor.

Possible reasons

Fractures of the foot bones are most often observed in adults and account for approximately 2-5% of the total number of all injuries. An interesting fact is that, according to doctors’ observations, the right leg is much more likely to undergo fractures than the left.

Since the foot consists of a large number of small bones, damage to one of them can provoke a disruption in the structure and activity of others, since they are all closely interconnected. When carrying out treatment, you should not forget about this and use complex therapy.

The most common causes of this type of injury include:

1. Falling from a great height or jumping and landing on your entire foot. In this case, the main force of the impact affects mainly the marginal bones of the foot.
2. Sudden flexion of the foot can occur when a vehicle suddenly brakes, hits a hard object, plays sports, or undergoes increased physical activity on the lower extremities.
3. A heavy object falling on the lower leg. In this case, not only a bone fracture can occur, but also skin damage or ligament rupture.

Damage to the bone tissue of the feet occurs spontaneously, regardless of the age and gender of the person. However, there are categories of people who are at increased risk of such injury. These include:

1. For football players, hockey players and weightlifters, participation in these sports carries an increased risk of foot injuries.
2. Pathologies of connective tissue of a systemic nature and increased fragility of bone tissue of a hereditary type. In this case, damage can occur even with the slightest physical impact on the leg.
3. Bone diseases such as osteoporosis.

Symptoms and diagnosis

The main symptoms of fractures of any location are:

• pronounced pain sensations,
• the appearance of swelling in the affected area,
• hemorrhages,
• impairment of motor activity of the injured limb.

However, upon closer examination, other signs characteristic of a cuboid bone fracture are noted. These include:

• acute pain, which intensifies with palpation and pressure on the 4th and 5th metatarsals,
• deformation and change in the contours of the foot,
• increased pain at the slightest attempt to move the foot.

If a fracture of the cuboid bone is accompanied by injury to the scaphoid bone or their dislocation, a deformity appears, depending on the severity of the displacement of the damaged bones. In this case, the force of deflection of the forefoot forward or backward plays an important role.

When palpating and pressing on all the toes, the pain intensifies, affecting all the bones of the foot.

Fractures that are accompanied by displacement, dislocation or subluxation of bones change the contours of the dorsum of the foot. In this case, a stepped deformation is observed. A fracture is also indicated by severe swelling and the appearance of hematomas in the affected area.

In order to determine whether there has been a fracture or a small puncture of bone tissue, the traumatologist first of all palpates the injured area and nearby areas of the limb. After this, the specialist asks the patient to move his fingers and the entire foot, studying the degree of difficulty in movement and paying attention to the presence of pain during a particular movement.

If a doctor suspects a fracture, he must refer the patient for an X-ray of the foot. It can be used to determine whether a bone fracture is present, as well as to determine the presence of bone fragments and deformation.

First aid and treatment

First of all, you should fix the ankle joint in one position. This is necessary in order to prevent the movement of fragments. For these purposes, you can use various available means, such as sticks and boards, or any fabric products. As a last resort, you can bandage the injured leg to the healthy one.

If the damage is of moderate severity, treatment is limited to applying a plaster cast to the damaged organ. This bandage is removed after 3-6 weeks. This method of therapy is necessary in order to completely fix the lower limb and prevent improper fusion of damaged bones.

If there is displacement, bone fragments or open damage to epithelial tissues, it is necessary to install fixing metal pins before applying plaster.

If a tear or complete rupture of the ligament fibers is detected, treatment can be carried out without plaster. However, a fixing bandage is still necessary. Most often, the doctor prescribes the wearing of a special bandage or orthopedic shoes. In order to prevent increased physical stress on the injured limb, it is recommended to use crutches.

Treatment of a fracture using medications is necessary to eliminate pain, reduce inflammation and speed up the healing process. For these purposes, analgesic and anti-inflammatory drugs are used. To eliminate hematomas and relieve swelling, the doctor may prescribe special ointments and gels with a resolving effect.
As additional therapy, the use of vitamin complexes and preparations containing calcium may be required.
It is quite difficult to unequivocally answer the question of how long it takes for a fracture to heal, since everything depends on the degree of damage and the individual characteristics of the body.

Rehabilitation and possible complications

After treatment is completed and the plaster cast is removed, slight swelling and mild pain may be present for some time. In order to speed up full recovery, the patient needs long-term rehabilitation, during which he must follow the following recommendations:

1. Do a kneading massage of the foot and lower leg.
2. Gradually increase physical activity by performing certain exercises.
3. Attend physical therapy procedures prescribed by your doctor.
4. Use arch supports. They must be worn for one year. For more severe injuries, the duration can increase to several years.
5. In most cases, the traumatologist may prescribe the patient to wear orthopedic shoes. It is advisable to do this for at least 6 months.

The foot bears a very heavy load every day. The weight of the entire body should be evenly distributed between the various bones of the limb. If any of them is damaged, the arch of the foot is disrupted, which, in turn, leads to a deterioration in shock absorption and support function. It is very important to detect a foot injury early and begin to treat it.

A bone fracture in the foot, regardless of its nature and location, requires immediate medical attention. Lack of treatment can lead to the development of serious complications, which often cause disability.

Clinical picture.

Cuboid bone of the foot- This is part of the lateral column of the foot. It articulates externally with the lateral cuneiform, navicular and calcaneus, and distally with the lateral metatarsals. Along the entire plantar surface, it takes part in the formation of the arch of the foot. It forms a groove for the tendon, so if the cuboid bone is damaged, the function of this muscle may be impaired.

Mechanogenesis of a fracture of the cuboid bone of the foot.

Direct types of injury: When force is applied to the outer dorsum of the foot, a fracture of the cuboid bone can occur.

Indirect types of injury:

Nutcracker type damage. Compression injuries of the cuboid bone that occur during forced outward movement of the forefoot. The cuboid bone is crushed between the bases of the fourth and fifth metatarsals and the calcaneus.

Strong plantar flexion leads to an isolated dislocation in the calcaneocuboid joint, for example, during dance movements or in a bicycle injury.

Stress fractures can occur in young athletes.

Carrying out diagnostics.

Clinical diagnosis. Patients complain of pain, as well as swelling along the inner dorsum of the foot.

Pain is felt on the outer surface of the foot, which, together with the symptom of peroneal tendinitis, may be evidence of a stress fracture of the cuboid bone.

Carrying out X-ray diagnostics. Oblique, lateral and anteroposterior projections of the foot are performed. A stress study is also carried out. Carrying out oblique projections helps to further visualize the outlines of the articular surface of the cuboid bone itself.

Carrying out computed tomography. This is an additional method for visualizing a fracture and is carried out in sagittal, frontal and axial projection. Helps to clarify the features of fragment displacement during complex injuries.

Treatment of fractures of the cuboid bone of the foot.

Indications for conservative treatment.

Isolated damage to the cuboid bone without signs of shortening or impression. The foot is fixed using a plaster splint for four to six weeks.

Surgical treatment.

Fractures that are combined with a displacement of the articular surface by two or more millimeters.

Fracture of the sphenoid bones.