The cuboid bone protrudes. Cuboid bone fracture photo. Symptoms of a fracture of the cuboid bone of the foot

For pain cuboid bone foot problems, it is recommended to go to the hospital immediately. Cause pain syndrome can be hidden both in ordinary fatigue and in a serious fracture. The cuboid bone is located in front of the heel. In its own way anatomical feature she has irregular shape. Any overexertion of the feet leads to severe pain.

Causes of pain syndrome

In most cases, pain develops due to injury. It is not so easy to damage this area of ​​the foot, but the likelihood of injury still remains. The main function of the cuboid bone is to form arches on the sole. As a result, a groove is formed that ensures full functioning of the tendons. Therefore, with any violations, muscle functionality decreases sharply.

The main causes of bone pain:

1. Mechanogenesis. Injuries fall into this category varying degrees gravity. These are usually fractures that result in cuboidal damage. Forced movements, accompanied by bone crushing, can provoke this process.
2. Excessive arching of the sole. This leads to dislocation of the cuboid bone. People involved in dancing and cycling are susceptible to this damage.
3. Stress fracture. It is more often recorded in novice athletes. At the same time, the person feels severe pain, swelling appears on the sole.
4. Peroneal tendonitis. This syndrome causes discomfort on the outside of the foot, indicating a fracture.

Only a specialist can identify the exact cause of pain after carrying out diagnostic measures.

Return to contents

Common causes of pain

The cuboid bone can be damaged due to a stress fracture. Novice athletes, due to the lack of rich experience, initially harm their health. Excessive exercise can cause cracks in the feet. This happens as a result of monotonous and persistent repetitions of the same movements. More often, this type of injury occurs during sports competitions. At the same time, the victim feels nagging pain, which intensifies over time.

In second place is a sprain. This is the most common cause of severe pain in the foot. In almost 85% of cases, it is the sprain that injures the cuboid bone. This happens as a result of inversion. A sprain can damage any ligament, even when the leg is twisted.

Cuboid bone syndrome. This cause is not recorded very often, but damage in this area leads to long-term pain. The process is observed when the foot is partially dislocated as a result of injury. The ankle may also be sprained. The pain is localized from the outer edge of the foot, its intensification is recorded in the morning and during physical activity. Without proper treatment, the symptom will not go away on its own.

Tarsal coalition. Extremely rare, this condition is caused by the fusion of bones with each other. The problem is congenital and manifests itself after 20 years. The pain syndrome occurs unexpectedly, and it is felt constant fatigue. A person can experience cramps at any time of the day. Surgery will help eliminate the pain.

Bunyon. This is a foot deformity that results in thumb turned inward. This anomaly is accompanied by severe pain and inflammatory processes. Sometimes a similar situation occurs with the little finger.

Corn. Pain in the cuboid bone does not always indicate the presence of a serious pathology or injury. Sometimes a callus just builds up in this place.

In some cases, it develops under the skin, making diagnosis difficult. A person experiences pain in the area of ​​the cuboid foot, but in fact there is a callus located there.

Tendinitis and arthritis can lead to discomfort and additional symptoms. All these conditions are accompanied by a pronounced clinical picture.

The foot is a complex anatomical system consisting of large number bones, muscle formations and ligaments. Due to constant pressure, the small bones of the foot are subject to great stress when walking, running and vertical position human body. Against the background of provoking factors (intense sports, injuries, etc.), their integrity may be impaired.

Every person should know what symptoms accompany a fracture of the scaphoid and cuboid bones. This allows you to receive the necessary medical care in a timely manner to ensure recovery. bone tissue and prevention negative consequences.

Clinical signs of scaphoid injury

The bone is located in the midfoot and has a flattened shape, which allows it to participate in maintaining the anatomical arch of the sole. It is tightly fixed to other bone formations with the help of a large number of ligaments that limit mobility in small joints legs.

With fractures, which are most often observed during trauma, the patient experiences the following symptoms:

• swelling and swelling of the tissues in the area of ​​the inner edge of the foot. Edema can involve a large anatomical area, up to ankle joint;
• with concomitant dislocation, palpation reveals an uncharacteristic bony protrusion;
• the patient loses the ability to put weight on his leg and move. Reflexively, the foot lowers the heel to the ground;
• not typical sharp pain, localized in one place;
• When you move the thumb, index and middle fingers of the injured leg, pain and discomfort intensify.

Symptoms and treatment of a scaphoid fracture are closely related, since effective therapy should begin as soon as possible after the injury.

Treatment approaches

Traumatologists know well how to treat a fracture of the navicular bone of the foot. In the absence of displacement of the fragments, it is sufficient to use immobilization in the form of a circular plaster cast. It is important to note that it is necessary to model the lower plantar arch using a metal instep support - this helps prevent flat feet.

If the patient has a displacement of bone fragments, then before immobilization for a fracture of the scaphoid bone, the fragments are repositioned. This intervention is always carried out with various types pain relief. In some cases, external fixation devices are used, which require wires to be passed through bone fragments.

The duration of therapeutic measures is 4-6 weeks, necessary for complete restoration of bone tissue. It is important to note that in people with degenerative changes in the bones, in old age and in the presence of concomitant pathologies, regeneration processes require more time.

In case of non-compliance with the doctor’s prescriptions, as well as the absence rehabilitation activities, bone fusion can take up to one year or more.

Rehabilitation for a fracture of the scaphoid includes the following measures:

• physical therapy and massage aimed at recovery motor function and muscle tone;
• visiting the pool with active involvement of the legs in the swimming process;
• use of special insoles and orthopedic shoes for 6 months or more;
• physiotherapeutic procedures in the form of electrophoresis, laser therapy, etc.

If therapy or rehabilitation is prescribed incorrectly, the treatment time for a fracture of the navicular bone of the foot is significantly extended. In addition, the patient may experience negative consequences of the injury: gait disturbances, flattening of the arches of the soles, curvature of the legs, shortening of the feet and disability.

Traumatic injuries of the cuboid bone

The cuboid bone is located on the outer part of the leg and is in contact with the scaphoid bone formation, as well as a number of small bones. It has a tetrahedral shape, which is how it got its name.

At various injuries There may be a violation of the integrity of the bone with the development of the following symptoms:

It is important for traumatologists to carry out differential diagnosis fractures of these bones. The main difference is the localization of damage along the inner edge of the foot in case of injury to the navicular bone, and along the outer edge in case of damage to the cuboid formation.

However, to confirm the diagnosis, targeted radiography of the bones of the foot in two or more projections should always be used, or CT scan.

Important! The diagnosis should not be made by the patient himself, as this may lead to improper treatment and the emergence of negative consequences of injury.

Therapeutic measures

Patients are often interested in how long it takes for a fracture of the cuboid bone of the foot to heal. It is believed that restoration of the necessary bone tissue strength is observed 6-8 weeks after injury. In this regard, it is during this period that the patient is given an immobilizing bandage, usually using plaster for a fracture.

For elimination pain, patients are prescribed painkillers: Ketorol, Indomethacin, Nise, etc. They help reduce the severity of pain and prevent the development of degenerative changes in damaged tissues.

In addition, great importance is given in therapy proper nutrition- the diet should be enriched with foods with high content protein, microelements and vitamins. Fatty, fried foods, as well as bakery and confectionery products should be excluded from it.

In addition to immobilization measures, the patient may undergo surgical reposition of bone fragments if they are displaced. In this case, the patient short term is hospitalized in a medical institution.

All methods of therapy should be selected only by the attending physician. When trying to self-medicate, complications may develop, including deformation. lower sections legs and disabilities.

Patient rehabilitation begins at the very beginning therapeutic measures. It includes dosed therapeutic exercises, restrictions on movement patterns in the first two weeks after injury, as well as physical therapy.

In addition, massage is widely used for a fracture of the cuboid bone, aimed at stimulating metabolic processes in the area of ​​injury.

Therapeutic massage should only be carried out by a specialist, since if there is excessive impact on bone formation, perhaps it will be damaged again.

Conclusion

Traumatic injuries to the bones of the foot lead to severe discomfort and a decrease in the quality of life of patients. Therefore, if any signs of injury appear, a person should immediately seek professional help. medical care. In addition to conservative and surgical treatment, proper rehabilitation, based on a complex of exercise therapy, massage and the use of orthopedic insoles or shoes.

In the first time after injury, the patient should be careful when physical activity and avoid any high load on the lower limbs: running, lifting weights and the like.

In contact with

Cuboid syndromeis a condition caused by damage to the joint and ligaments surrounding the cuboid bone. The cuboid bone is one of the bones of the foot.

Cuboid syndrome is accompanied by pain on the side of the foot on the side of the fifth (small) toe. Often the patient feels pain in the middle of the foot or at the base of the fourth and fifth toes.

Cuboid syndrome results from partial subluxation of the transverse tarsal joint. This occurs after a sudden injury or excessive stress on the joints of the foot.

Cuboid syndrome - symptoms

Cuboid syndrome causes pain on the lateral side of the foot. The pain may appear suddenly or develop gradually.

Symptoms of cuboid syndrome

• pain on the lateral side of the foot (from the fifth toe);
• the pain may be sharp;
• very difficult to jump;
• possible swelling;
• pain may intensify when standing on your heels;
• reduced range of motion of the foot or ankle;
• tenderness of the bottom of the foot;
• lower back pain.

Cuboid bone syndrome - causes

Dancers and athletes are at greatest risk of developing cuboid syndrome.

Most common reasons are overuse or injury. Injuries typically develop after long periods of intense activity, such as running.

The injury that results in cuboid syndrome is an inversion ankle sprain. A study found that 40% of people with ankle sprains may develop the condition.

Cuboid syndrome is also common in people with adducted feet, which means their feet turn inward when they walk.

Other factors causing this syndrome:

• playing sports such as tennis;
• climbing stairs;
• poorly chosen shoes;
• running on uneven surfaces.

Cuboid bone syndrome - diagnosis

The foot is a complex, flexible and durable part of the body. It contains about 100 muscles, ligaments and tendons, 28 bones and 30 joints. Complex structure foot and nonspecific nature of pain in cuboid syndrome make its diagnosis difficult. Sometimes x-rays or magnetic resonance imaging (MRI) will show no signs of the condition, even if severe pain is present. Cuboid syndrome can mimic symptoms of other foot conditions, such as a fracture or heel spurs.

Cuboid syndrome can develop at the same time as a fracture in another part of the foot. However, fractures of the cuboid bone itself are rare. To make a diagnosis and select the most effective treatment, the doctor will conduct a thorough clinical examination and study the medical history in detail.

Cuboid bone syndrome - treatment

Treatment for cuboid syndrome begins with rest and reducing or eliminating activity.

Additional treatments include:

• using a pillow to stabilize the foot joints;
• wearing orthopedic shoes;
• taking anti-inflammatory drugs to reduce pain and swelling;
• deep massage of the calf muscles.

The length of time it usually takes to recover from cuboid syndrome depends on many factors, including:

• how long ago the person had the injury;
• was this caused acute injury or developed over time;
• whether it developed as part of another injury, such as a foot sprain.

If the initial injury was minor, most people begin to feel relief within a few days. However, if a person has other injuries, such as a sprained foot, recovery may take up to several weeks.

Physical therapy (physical therapy) can play important role in ensuring full recovery.

Exercise therapy includes:

• strengthening the foot;
• stretching of the muscles of the foot and lower leg;
• exercises to improve balance.

Literature

1. Hagino T. et al. A case of cuboid bone stress fracture in a senior high school rugby athlete //Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology. – 2014. – T. 1. – No. 4. – pp. 132-135.
2. Martin C., Zapf A., Herman D. C. Cuboid Syndrome: Whip It Good! //Current sports medicine reports. – 2017. – T. 16. – No. 4. – P. 221.
3. Patterson S. M. Cuboid syndrome: a review of the literature //Journal of sports science & medicine. – 2006. – T. 5. – No. 4. – P. 597.

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, in which adequate treatment has already been performed. conservative treatment, 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 due to 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.

The return to regular shoes is determined by the severity of pain and residual swelling, the presence radiological signs adhesions.

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 a 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.

Exist various techniques surgical interventions. 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.

For comminuted fractures the only way Restoring the length of the lateral column of the foot can be done using a bridge-like osteosynthesis with a plate. If the fracture is accompanied by severe soft tissue damage, the only possible method treatment 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 recovery is impossible normal shape and foot function.

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 go 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 you finally make a decision on surgical treatment, we prescribe our patients a course of high-energy shock wave therapy.

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

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, it is recommended complex treatment and an appropriate period of rehabilitation, since a change in the shape of any of them can lead to a violation of 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. on her bottom surface there is a concavity, and on the outside there is a characteristic lumpiness, which 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 outer surface Feet.

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

, which 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 areas sphenoid bones
• and talus;
• Road accident - the cause of the fracture is compression;
• 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 injury, fractures of the scaphoid bone in the area of ​​its dorsal part, body or tubercle are possible. Often in back side of the foot, bone fragments are displaced.

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.

TO characteristic 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 cause damage to the surrounding soft fabrics. To identify all damage, in some cases, computer or magnetic resonance imaging is prescribed.

Treatment methods

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 lower limb.

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

In severe cases, surgical treatment is performed, after which it is necessary to wear a plaster cast. less than a month. To control dynamics they do x-rays. It is necessary to understand that everything 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

Late application to medical institution or failure to comply with all the doctor’s instructions for a fracture of the cuboid or scaphoid often leads to complications.

These include:

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

At 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 move on 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 while 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. Performed at the most early stages, before removing the cast 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.

Exercise therapy

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 hip and knee joints, pressure on the surface of the sole using a support or the hands of an assistant. 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. Good effect spotted 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 you experience pain or muscle spasm you should stop immediately and stop exercising. Load injured leg it needs to be done gradually.

Additional events

In addition to all of the above rehabilitation measures, after discharge from the hospital it will be useful to undergo Spa treatment, continue to eat right, do hiking 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. Conclusion about full recovery 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 no less long recovery period. You should always be careful and try to avoid situations that could lead to a fracture. Human body- a fragile thing, so you need to take care of it.