| Cuneiform fracture | |
|---|---|
| Other names | Medial Cuneiform Fracture, Intermediate Cuneiform Fracture, Lateral Cuneiform Fracture, Isolated Cuneiform Fracture, Cuneiform Dislocation, Isolated medial cuneiform fracture, Cuneiform Stress Fracture [1] |
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| An X-ray of a Medial cuneiform fracture | |
| Specialty | Orthopedics |
A Cuneiform fracture is an injury of the foot in which one or more of the Cuneiform bones are fractured. [2] The annual incidence of cuboid fracture is 1.8 injuries per 100,000 population. [3]
People who have suffered acute fractures to one or more cuneiform bones typically have excruciating pain over their dorsal or dorsomedial foot. They also have trouble walking on their toes and bearing weight. Usually, there is a region of localized ecchymosis, tenderness, and swelling between the Lisfranc and Chopart joints. [4]
While cuneiform fractures are fairly rare, the most commonly fractured cuneiform bone is the Medial cuneiform, typically the cause of a cuneiform fracture is by physical trauma (direct blow) to the cuneiform, as well as the result of an avulsion fracture and a result of axial load, [5] but can also be the result of a stress reaction that progressed with continued weight-bearing and physical activity. [1]
Cuneiform fractures can be very difficult to diagnose because of the complex overlapping articulations of the midfoot, which can make them invisible on plain films. Therefore, identification might need for more sophisticated imaging, like CT or MRI. [6]
A cautious reduction is necessary for dislocated cuneiform bones, regardless of the best time to begin therapy. [7]
The right kind of internal fixation needs to be selected after a dislocation has been reduced. When it comes to treating fractures, casting seems to work best for nondisplaced fractures, and open reduction and internal fixation with screws seems to work best for displaced fractures. K-wires can be used to temporarily transfix isolated dislocations and fracture dislocations; these wires are usually removed after six weeks. [7]
The foot is an anatomical structure found in many vertebrates. It is the terminal portion of a limb which bears weight and allows locomotion. In many animals with feet, the foot is a separate organ at the terminal part of the leg made up of one or more segments or bones, generally including claws and/or nails.
The metatarsal bones, or metatarsus, are a group of five long bones in the midfoot, located between the tarsal bones and the phalanges (toes). Lacking individual names, the metatarsal bones are numbered from the medial side : the first, second, third, fourth, and fifth metatarsal. The metatarsals are analogous to the metacarpal bones of the hand. The lengths of the metatarsal bones in humans are, in descending order, second, third, fourth, fifth, and first. A bovine hind leg has two metatarsals.
The ankle, or the talocrural region, or the jumping bone (informal) is the area where the foot and the leg meet. The ankle includes three joints: the ankle joint proper or talocrural joint, the subtalar joint, and the inferior tibiofibular joint. The movements produced at this joint are dorsiflexion and plantarflexion of the foot. In common usage, the term ankle refers exclusively to the ankle region. In medical terminology, "ankle" can refer broadly to the region or specifically to the talocrural joint.
There are three cuneiform ("wedge-shaped") bones in the human foot:
A bone fracture is a medical condition in which there is a partial or complete break in the continuity of any bone in the body. In more severe cases, the bone may be broken into several fragments, known as a comminuted fracture. A bone fracture may be the result of high force impact or stress, or a minimal trauma injury as a result of certain medical conditions that weaken the bones, such as osteoporosis, osteopenia, bone cancer, or osteogenesis imperfecta, where the fracture is then properly termed a pathologic fracture.
The Maisonneuve fracture is a spiral fracture of the proximal third of the fibula associated with a tear of the distal tibiofibular syndesmosis and the interosseous membrane. There is an associated fracture of the medial malleolus or rupture of the deep deltoid ligament of the ankle. This type of injury can be difficult to detect.
A joint dislocation, also called luxation, occurs when there is an abnormal separation in the joint, where two or more bones meet. A partial dislocation is referred to as a subluxation. Dislocations are often caused by sudden trauma on the joint like an impact or fall. A joint dislocation can cause damage to the surrounding ligaments, tendons, muscles, and nerves. Dislocations can occur in any major joint or minor joint. The most common joint dislocation is a shoulder dislocation.
A shin splint, also known as medial tibial stress syndrome, is pain along the inside edge of the shinbone (tibia) due to inflammation of tissue in the area. Generally this is between the middle of the lower leg and the ankle. The pain may be dull or sharp, and is generally brought on by high-impact exercise that overloads the tibia. It generally resolves during periods of rest. Complications may include stress fractures.
The tibialis posterior muscle is the most central of all the leg muscles, and is located in the deep posterior compartment of the leg. It is the key stabilizing muscle of the lower leg.
A Lisfranc injury, also known as Lisfranc fracture, is an injury of the foot in which one or more of the metatarsal bones are displaced from the tarsus.
Neuropathic arthropathy, also known as Charcot joint after the first to describe it, Jean-Martin Charcot, refers to progressive degeneration of a weight-bearing joint, a process marked by bony destruction, bone resorption, and eventual deformity due to loss of sensation. Onset is usually insidious.
A hip dislocation is when the thighbone (femur) separates from the hip bone (pelvis). Specifically it is when the ball–shaped head of the femur separates from its cup–shaped socket in the hip bone, known as the acetabulum. The joint of the femur and pelvis is very stable, secured by both bony and soft-tissue constraints. With that, dislocation would require significant force which typically results from significant trauma such as from a motor vehicle collision or from a fall from elevation. Hip dislocations can also occur following a hip replacement or from a developmental abnormality known as hip dysplasia.
The Lisfranc ligament is one of several ligaments which connects the medial cuneiform bone to the second metatarsal. Sometimes, the term Lisfranc ligament refers specifically to the ligament that connects the superior, lateral surface of the medial cuneiform to the superior, medial surface of the base of the second metatarsal.
A calcaneal fracture is a break of the calcaneus. Symptoms may include pain, bruising, trouble walking, and deformity of the heel. It may be associated with breaks of the hip or back.
A trimalleolar fracture is a fracture of the ankle that involves the lateral malleolus, the medial malleolus, and the distal posterior aspect of the tibia, which can be termed the posterior malleolus. The trauma is sometimes accompanied by ligament damage and dislocation.
Mandibular fracture, also known as fracture of the jaw, is a break through the mandibular bone. In about 60% of cases the break occurs in two places. It may result in a decreased ability to fully open the mouth. Often the teeth will not feel properly aligned or there may be bleeding of the gums. Mandibular fractures occur most commonly among males in their 30s.
A patellar dislocation is a knee injury in which the patella (kneecap) slips out of its normal position. Often the knee is partly bent, painful and swollen. The patella is also often felt and seen out of place. Complications may include a patella fracture or arthritis.
Dislocations occur when two bones that originally met at the joint detach. Dislocations should not be confused with subluxation. Subluxation is when the joint is still partially attached to the bone.
Medial knee injuries are the most common type of knee injury. The medial ligament complex of the knee consists of:
A pilon fracture, is a fracture of the distal part of the tibia, involving its articular surface at the ankle joint. Pilon fractures are caused by rotational or axial forces, mostly as a result of falls from a height or motor vehicle accidents. Pilon fractures are rare, comprising 3 to 10 percent of all fractures of the tibia and 1 percent of all lower extremity fractures, but they involve a large part of the weight-bearing surface of the tibia in the ankle joint. Because of this, they may be difficult to fixate and are historically associated with high rates of complications and poor outcome.