Treatment of fractures of the cuboid and navicular bones. Fractures of the cuboid bone Cuboid bone of the hand fracture

Fractures of the bones of the foot often make up a tenth of all fractures. The cause of their occurrence is not only damage of a direct nature, but also unsuccessful landings on the foot, its tucking, various falls.

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

Bone Anatomy

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

metatarsal;
tarsal;
phalanges of fingers.

The sphenoid and scaphoid are located in the region of the tarsus, forming this section together with the calcaneus, talus and three sphenoid bones.

The navicular bone is located closer to the inner edge of the foot. Behind it is connected to the talus bone, and in front - with three sphenoid. There is a concavity on its lower surface, and a characteristic tuberosity is noted on the outside, which is well felt through the skin.

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

The scaphoid and cuboid bones carry the support load when walking, taking 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 the wrong treatment tactics. It is important to seek medical attention in a timely manner for any injuries.

Fracture of the scaphoid

Among all the causes of scaphoid fractures, the main cause 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 tibial muscle during exercise. This leads to the separation of the bone fragment, which is attached to this muscle.

Other reasons include:

injuries arising from violent intense flexion in the plantar part of the foot, resulting in the clamping of the navicular bone between the areas of the sphenoid bones and the talus;
road accident - the cause of the fracture is compression;
unsuccessful landing after jumping or falling from a height;
fatigue fractures - occur in ballet workers, professional athletes and gymnasts due to prolonged high loads on the foot, which entail the restructuring of bone structures.

As a result of trauma, fractures of the navicular bone in the region 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 proposed fracture, often extending to the ankle joint;
bone fragments are well palpable under the skin (when displaced);
the support function suffers, the victim can only lean on the heel;
movements of the foot up and down and left and right are not possible.

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

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

Cuboid fracture

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

Typical symptoms include:

pain that worsens when you try to move your feet;
swelling from the back-inner surface of the foot;
inability to fully lean on the foot;
palpation reveals a characteristic deformation (indicates displacement of bone fragments).

X-rays are of decisive importance in making an accurate diagnosis.

Important! Fractures of the cuboid or navicular often damage the surrounding soft tissues. In some cases, computed tomography or magnetic resonance imaging is prescribed to identify all injuries.

Methods of treatment

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

It is necessary to model the lower arch of the foot. When a bandage in the form of a "boot" is applied, a metal arch support is additionally installed, which is necessary to prevent flattening of the arch of the lower limb.

When bone fragments are displaced, reposition is needed under intraosseous anesthesia or intravenous anesthesia. Dislocation and fracture of the scaphoid requires the installation of a special Circass-zade design, when one spoke is passed through the calcaneus, 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 control the dynamics, x-rays are taken. It must be understood that all bone structures in the foot are interconnected, so you need to completely restore the fracture site.

Important! In the case of multi-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. In this capacity, the tibial area or artificial materials can act.

Possible Complications

Untimely access to a medical institution or non-compliance with all the prescriptions of the attending doctor in case of a fracture of the cuboid or scaphoid bone often leads to complications.

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

With surgical treatment, the consequence may be a 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 complete a full course of rehabilitation measures.

Rehabilitation

After applying a plaster cast for fractures of the cuboid or navicular bones, it is recommended to give the leg rest 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 task of all rehabilitation measures is the restoration of the anatomical integrity of the foot bones, the normalization of its spring functions. This is necessary to soften the repulsion and protect the internal organs from a variety of sharp shocks in the process of walking and shaking when jumping or running.

Rehabilitation includes several activities.

Massage

It is necessary to restore full blood supply, nourish tissues and prevent the development of muscle atrophy. It is performed at the earliest possible time, before the plaster is removed from the leg. Helps relieve swelling and symptoms of pain.

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

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

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

Physiotherapy

It is carried out in conjunction with massage, helps relieve pain and swelling. The most commonly prescribed procedures are magnetotherapy, electrical stimulation, interference currents, electrophoresis and UHF.

Physical exercises while wearing a cast are necessary to improve blood circulation, exercises increase the tone of the whole body.

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

The second stage of exercise therapy is the restoration of mobility in the joints. It is necessary to return the support and spring functions of the foot, to strengthen the muscular frame. To do this, you need to perform exercises for bending the sole and unbending it, grab stuffed balls, small objects with your foot and fingers, and work on simulators. The main task of all exercises is to restore full walking.

Swimming pool

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

Proper nutrition

It is useful to consume foods high in calcium and vitamin D. It is necessary to include fermented milk products, milk and seafood in the diet. Recommended vitamin and mineral complexes.

The final stage of all these activities is the complete restoration of the biomechanics of walking. You have to learn how to jump and run again. Strengthening the endurance of the muscles of the lower limb plays a huge role. Jumps, jumps and running exercises will be useful.

Important! All classes in the recovery period should be performed under the supervision of specialists and with their help. If pain or muscle spasm occurs, you should immediately stop and stop exercising. You need to load the injured leg gradually.

Additional activities

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

flexion and extension of the toes;
standing on tiptoe, followed by lowering on the heels;
foot turns to the right and left;
rolling the 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.

Be sure to wear an arch support, orthopedic shoes, a special insole or orthosis for a long time. The conclusion about the full recovery is given by a traumatologist or orthopedist.

Conclusion

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

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

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

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

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

The most common variant of a cuboid fracture is an avulsion fracture in the region of its outer surface.

The separation occurs in the area of attachment of the calcaneocuboid ligament, and the bone fragment, in fact, is torn off along with it.

These fractures are best seen on radiographs or CT scans.

Often they are missed, mistaking the damage for a simple "sprain".

Patients describe the typical mechanism of injury as twisting of the foot, often with the foot tucked inward.

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

Careful examination in such cases makes it possible to distinguish damage to the external ligaments of the ankle joint from an avulsion fracture of the cuboid bone.

The severity of subcutaneous hemorrhage and bruising with such fractures may be different.

Conservative treatment

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

Surgery

Surgical intervention in patients with avulsion fractures of the cuboid bone is rarely indicated.

The operation is indicated primarily for patients with clinically pronounced false joints after an avulsion fracture, in 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.

Compression fractures are the second most common scaphoid fracture.

This variant of fractures occurs due to a relatively higher energy injury, most often in a fall on the foot.

These fractures are also often associated with Lisfranc injuries or other fractures/dislocations of the tarsometatarsal joints, which require special attention.

Patients usually report a history of high-energy trauma.

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

All patients after a high-energy injury that led to a fracture of the cuboid bone undergo computed tomography, since combined injuries of the tarsal and metatarsal bones in such patients are also not uncommon.

Conservative treatment

Patients with isolated fractures of the cuboid bone without displacement or with minimal displacement are shown to be immobilized with a short plaster splint, which allows the possibility of loading the leg.

Upon termination of immobilization, the gypsum splint changes to an orthopedic boot and a dosed load on the foot is allowed.

The return to normal shoes is determined by the severity of pain and residual edema, the presence of radiological signs of adhesion.

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

Surgery

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

Most physicians agree that the cuboid 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 foot deformity, 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 aim to restore this length of the lateral column.

There are various methods of surgical interventions. In our practice, we restore the length of the lateral column by 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 crushing of its articular surface.

In case of multi-comminuted fractures, the only way to restore the length of the lateral column of the foot can be bridge osteosynthesis with a plate. If the fracture is accompanied by severe soft tissue injury, external fixation may be the only possible treatment. 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.

Fractures due to lack of bone tissue, or stress fractures of the cuboid bone, are usually characterized by the gradual development of pain in the region of the outer edge of the foot, aggravated by physical activity.

These fractures are rare and often go undiagnosed.

Diagnosis often requires advanced imaging techniques.

Stress fractures of the cuboid bone are common in athletes.

Conservative treatment

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

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

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

At the end of immobilization, the degree of load on the leg and the 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 still has pain despite adequate conservative treatment.

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

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 a heavy object strikes the back of the foot, a person does not experience much anxiety, in addition to pain and swelling. However, a strong blow is one of the main reasons for the formation of a bone fracture 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 bones of the foot in most cases are observed in adults and account for approximately 2-5% of the total number of all injuries. An interesting fact is that, according to the observations of doctors, 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 violation of the structure and activity of others, since they are all closely related. When carrying out treatment, one should not forget about this and use complex therapy.

The most common causes of this type of injury include:

A fall from a great height or a jump with a landing on the whole foot. In this case, the main impact force affects mainly the marginal bones of the foot.
A sharp flexion of the foot can occur when the vehicle brakes sharply, hits a hard object, during sports and increased physical exertion on the lower limbs.
Falling on the lower leg of a heavy object. In this case, not only a bone fracture can occur, but also damage to the skin or rupture of the ligaments.

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 an injury. These include:

Football players, hockey players and weightlifters playing these sports carry an increased risk of foot injury.
Pathologies of the connective tissue of a systemic nature and increased fragility of the bone tissue of a hereditary type. In this case, damage can occur even with the slightest physical impact on the leg.
Bone diseases such as osteoporosis.

Symptoms and Diagnosis

The main symptoms of fractures of any localization are:

pronounced pain,
the appearance of swelling in the affected area,
hemorrhage,
impaired motor activity of the injured limb.

However, with a more thorough examination, other signs characteristic of a cuboid fracture are noted. These include:

acute pain, which increases with palpation and pressure on the 4th and 5th metatarsal bones,
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 trauma to the navicular 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 probing and pressing on all the toes on the foot, the pain intensifies, affecting all the bones of the foot.

Fractures that are accompanied by displacement, dislocation or subluxation of the bones change the contours of the dorsum of the foot. In this case, a stepwise 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 the bone tissue, the traumatologist first of all performs palpation of the injured area and the nearest parts of the limb. After that, the specialist asks the patient to move his fingers and the whole foot, studying the degree of difficulty in movement and paying attention to the presence of pain during a particular movement.

If the doctor has suspicions of a fracture, he necessarily directs the patient to an x-ray of the foot. It can be used to find out if a bone fracture is present, as well as to determine the presence of bone fragments and deformities.

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 improvised means, such as sticks and boards, any fabric products. In extreme cases, you can bandage the injured leg to a 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.

In the presence of displacement, bone fragments or open damage to epithelial tissues, it is necessary to install fixing metal wires 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 wearing a special bandage or orthopedic shoes. In order to prevent increased physical load on the injured limb, it is recommended to use crutches.

Treatment of a fracture with drugs is necessary to eliminate pain, reduce inflammation and accelerate 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 an additional therapy, the use of vitamin complexes and preparations containing calcium may be required.
It is rather difficult to unequivocally answer the question of how long a fracture heals, since it all depends on the degree of damage and the individual characteristics of the organism.

Rehabilitation and possible complications

After the end of treatment and the removal of the plaster cast, there may be slight swelling and slight pain for some time. In order to accelerate full recovery, the patient needs a long-term rehabilitation, during which he must comply with the following recommendations:

Do a kneading foot and leg massage.
Gradually increase physical activity by performing certain exercises.
Attend physical therapy sessions prescribed by your doctor.
Use supinators. They must be worn without fail for one year. With more severe injuries, the duration can increase to several years.
In most cases, the traumatologist can prescribe the patient to wear orthopedic shoes. It is advisable to do this for at least 6 months.

There is a lot of stress on the foot every day. The weight of the whole body should be evenly distributed among the various bones of the limb. In the event of damage to any of them, a violation of the arch of the foot occurs, which, in turn, leads to a deterioration in cushioning and support function. It is very important to detect a foot injury in a timely manner and start treating 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.

A broken foot 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 daily, the lack of minimal knowledge about the prevention of foot fractures make this complex anatomical formation especially vulnerable.

Anatomical excursion

Foot - the lower part of the lower limb, which has a vaulted structure and is designed to absorb shocks that occur when walking, jumping and falling.

The feet perform two main functions:

firstly, they hold body weight;
secondly, they provide 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 the bones in the human body are located in the feet), the 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 high-strength, so dislocation of the foot occurs much less frequently than a fracture.

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

Heel. It is the largest bone in the foot. It has the shape of a complex three-dimensional rectangle with depressions and protrusions, to which muscles are attached and along which nerves, vessels and tendons pass.
Ram (supracalcaneal). It stands in second place in size, is unique in the high percentage of the 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.
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 tendon of the long peroneal muscle can fully work.
Scaphoid. Forms joints with the talus and three sphenoid bones. Occasionally, the development of this bone is disturbed and the 27th bone of the foot can be observed - an additional navicular bone connected to the main cartilage. With unskilled reading of the x-ray, the accessory bone is often mistaken for a fracture.
Wedge-shaped. From all sides attached to other bones.
Metatarsal. Short tubular bones serve for cushioning.
Phalanges of fingers. 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.
Sesamoid. Two very small (smaller than a pea), but extremely significant round bones, are located inside the tendons and are responsible for flexing 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;
calcaneal - 4%, of which 83% - as a result of a jump on straight legs from a great height;
cuboid - 2.5%;
scaphoid - 2.3%;
metatarsal - the most common type of injury to the foot bone.

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

The average duration of disability for a toe injury is 19 days. For children, such an injury is not typical, there are incomplete fractures (cracks).

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

Causes of injury

Fracture of the bones of the foot can occur for several reasons:

falling heavy objects on the foot;
jump (fall) from a great height with landing on the 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 has been injured.

Calcaneal fracture

The main cause of occurrence is landing on the heels when jumping from a considerable 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 calcaneus and splits it into pieces.

Fractures are usually unilateral, usually complex.

A fatigue fracture of the calcaneus stands apart, the main cause of which is chronic overload of a bone that has anatomical defects.

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

Talus injury

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

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

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

cuboid fracture

The main reason for the occurrence of a fracture is the fall of a heavy object on the leg, a fracture due to impact is also possible.

As is clear from the mechanism of occurrence, usually unilateral.

Fracture of the scaphoid

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

Recently, fatigue fractures of the navicular bone have been noted, which used to be a rarity - this is primarily due to an increase in the number of non-professional athletes who exercise without medical and coaching support.

Sphenoid bone injury

The consequence of a heavy object falling on the dorsum of the foot and crushing the sphenoid bones between the metatarsal and scaphoid bones.

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 frequently diagnosed, are divided into traumatic (arising from a direct blow or twisting

foot) and fatigue (caused by foot deformity, 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).

Injury of the phalanges of the fingers

A fairly common fracture, usually caused by direct trauma.

The phalanges of the fingers are not protected 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: there are transverse, oblique, T-shaped, comminuted fractures. Displacement, if observed, is usually on the proximal phalanx of the thumb.

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

Sesamoid fracture

Relatively rare type of fracture. The bones are small, located under the end of the metatarsal bone of the big toe, usually broken due to sports activities associated with a large load on the heel (basketball, tennis, long walking).

Sometimes it is easier to remove sesamoid bones than to treat a 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 with a fracture with displacement.

Not all symptoms may be observed, the severity of the signs depends on the specific injury.

Specific features:

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

with a 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 flexion position;
with cuboid and navicular fractures: acute pain at 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 performed in one or two projections, depending on the location of the alleged fracture.

If a talus fracture is suspected, X-ray examination is not informative, and computed tomography is the optimal diagnostic method.

First aid

The only type of first aid for a suspected foot fracture is to ensure the immobility of the foot. It is carried out in mild cases by a ban on movement, in the rest - by imposing a tire.

Then the victim should be taken to the clinic. If swelling occurs, ice can be applied.

Therapeutic measures

Treatment depends on several factors:

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

Treatment consists of applying a plaster splint, plaster bandage, dressing or fixative, surgical or conservative treatment, including physiotherapy exercises and special massage.

Surgical treatment is carried out in exceptional cases - for example, with fractures of the sphenoid bones with displacement (in this case, an operation with transarticular fixation with a metal Kirschner wire is indicated) or with fractures of the sesamoid bones.

Recovery after injury

Recovery after an injury is achieved through special massage and exercise therapy, reducing the load on the injured limb, using orthopedic insoles, arch supports, heel pads and not wearing heels for a long period.

With fractures of the sphenoid bones, prolonged pain can be observed.

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 received treatment.

That is why it is important, if symptoms of an 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 athletes to the fact that a thoughtless increase in loads and the use of unsuitable shoes during classes is a direct way to close your opportunity to do physical education forever.

Even a high-quality recovery after a foot injury will never allow you to return to super-saturated workouts. 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 both on the inner side (medial), and on the outer (lateral), in the arch, instep, in the upper part and on the soles, sharp and, on the contrary, aching.

In accordance with 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.

Consider 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 is a simple diagnostic guide. Read and 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 resulting from the same, repetitive movements during sports activities.

What areas are affected the most? The location of the pain depends on what is damaged. Calcaneus or navicular fractures cause pain on the side of the foot; metatarsal stress fractures cause pain on either side of the foot.

In this case, it usually hurts at first not much, pulling, but gradually the condition worsens.

2) Ankle sprain

Ankle sprains are the most common cause of sharp pain in the foot area, on the outside of it (from ankle injuries). It accounts for up to 85%. This happens to the ankle when inverted.

Any ligament can be stretched, but the most common is the anterior talo-fibular ligament. It is damaged when we twist the leg inward. The ankle is displaced outward. This is known as an inversion injury. It ruptures some or all of the fibers in the ligament, causing severe pain, swelling, bruising, and joint instability.

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

3) Cuboid syndrome

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

It occurs when one of the small bones in the foot is partially dislocated after an injury such as a sprained ankle or as a result of constant overexertion of the foot.

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

If the foot does not go away for more than 3 months, the next thing to suspect after the ankle is cuboid bone syndrome, which occurs in up to 7% of people with ankle sprains.

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 overstressed, which causes its irritation, inflammation and degeneration.

It is usually caused by frequent long distance running, abnormal foot position, muscle imbalance, and occurs after an ankle sprain. With tendinitis, the condition worsens gradually over several weeks or months, and the foot is especially sore with the first steps in the morning, as well as with the start of activities after rest.

5) Tarsal Coalition

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

The condition is due to the fact that 2 or more bones fuse together. This is a congenital problem and symptoms usually appear in the second decade of life.

They often come very unexpectedly, it is pain, fatigue and convulsions. It may 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 immobilization of the foot.

6) Bunion

Bunion is a common cause of deformity and pain in the big toe.

It develops when the thumb is turned inward, pointing at others. This causes the bones at the base of the thumb to bulge out. 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.

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

7) Corns

Calluses appear on any part of the leg, often behind, above and on the side. They form when an area of skin is subjected to repeated friction and it tries to protect itself by building up additional layers.

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

8) Tibialis posterior 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 tendonitis, this tendon develops when the tendon becomes irritated, inflamed, or dystrophic, usually due to constant abnormal stress or injury.

The pain increases with activity and recedes when the legs are given rest. Tendonitis sufferers often have flat feet.

9) Arthritis

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

How to diagnose your condition

As you can see, there are a number of different causes of the ailment in question. If the problem is related to trauma, then it is most likely a sprain or cuboid syndrome, if the pain came on gradually, it could be a stress fracture or tendonitis. In adolescents, it is more likely to be associated with a tarsal coalition. People over the age of 50 are more likely to have arthritis. If the skin feels dry and thick, callus or callus tissue.

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Cuboid fracture

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

Among fractures of the bones of the foot, fractures of the cuboid bone account for about 2.5%, and among fractures of the bones of the skeleton - 0.14%.

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

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

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

Causes and mechanisms

Fractures of the cuboid bone occur due to direct trauma, for example, a blow and a heavy object falling on the foot.

Symptoms

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

But a careful study reveals symptoms 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, stepped appearances with displacement of fragments, exacerbation of pain with axial pressure on the IV-V metatarsal bones, when trying to remove or bring the forefoot, with 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 that depends on the degree of displacement of the fragments with a flattening of the arch with a deviation of the forefoot outward or inward.

On palpation, exacerbation of pain occurs when touching all the bones of the site, with axial pressure on all toes.

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

Diagnostics

The final diagnosis is established after X-ray examination.

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

Os regoneum - turns out to be under the tuberosity of the cuboid bone, at the junction of the cuboid and calcaneal bones and can consist of two parts - os cuboideum secundarium in the form of a process of the cuboid bone, which goes towards the navicular bone os cuboideum secundarium - a bone that is located between the calcaneus, talus , cuboid and navicular bones.

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

First aid

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

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

In extreme cases, you can bandage the injured leg to a healthy one.

Treatment

Usually, cuboid fractures are not accompanied by severe displacement of fragments, as well as fractures of the sphenoid bones.

Therefore, the treatment is reduced to immobilization with a plaster bandage of the “boot” type, in the plantar part of which a metal arch support is built.

A plaster bandage is applied from the fingertips to the middle third of the lower leg 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, it is forbidden to walk, then a dosed load on the injured leg is allowed.

After removing the immobilization, the patient is prescribed physiotherapy, mechanotherapy for the development of the ankle joint, physiotherapy exercises. Ability to work returns in about 8-10 weeks.

Why does my foot hurt when walking?

After each kilometer traveled, the legs are subjected to a load of 60 tons. Although the limbs are able to withstand a lot, they are also subject to stress and disease.

Diseases of the forefoot

The front third of the foot consists of metatarsal bones, phalanges and ligaments between them. Calluses, blisters, fungal infections, hammer toes, Morton's neuroma, hallux valgus, gout - various conditions are associated with the pathology of these elements of the foot. Metatarsalgia refers to any pain that has no known cause. Traumatic injuries or too narrow shoes increase the likelihood of pain in the foot when walking.

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

Extensor tendonitis of the foot develops due to constant overexertion of the lower leg - prolonged walking in uncomfortable shoes can be the main cause. The pain gets worse when you try to bend or straighten your fingers.

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

Diseases of the midfoot

The middle third of the foot is represented by the bones of the tarsus and their joints. They account for a significant part of the medial longitudinal arch of the arch of the foot. Pain in the midfoot when walking occurs as a result of stress fractures, pinching of the lateral plantar nerve, equine deformity (associated with too high an arch), sprains of the tibial posterior tendon, tibial nerve syndrome, extensor tendinitis. Treatment directly depends on the diagnosis, with which it is better not to delay, since cascading pains can be aggravated.

Fractures of the second, third, and fourth metatarsals are common in people who do morning jogging. Gradually it is felt that the foot of the leg hurts when walking. The pain rises, accompanied by swelling.

The navicular runs along the inside of the midfoot and its fractures are more complex. Initially, the pain is disturbing only during exertion and disappears 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 due to the anatomy of the first and second metatarsal bones, which do not have ligaments. This leads to dislocations during sharp turns or jumps.

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

If the foot hurts when walking, the influence of shoes cannot be ruled out, especially for people who play sports, have a child, suffer from arthritis. Too soft sole flexes and does not support the foot, so after any walk there is discomfort.

Diseases of the back of the foot

The back third of the foot consists of the calcaneus and talus, and the joints that connect them together. The answer to the question of why the heel hurts lies in the anatomy of the foot. When walking, the heel is the first to hit the ground, and huge forces affect 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 contusion, stress fractures, tarsal tunnel syndrome, medial calcaneal nerve entrapment, Achilles tendon bursitis, and calluses affect the heels, with the left foot affected more often than the right.

How to restore the ease of walking?

Any disease is easier to prevent, since irreversible processes require expensive and protracted treatment. Care is the main condition for the beauty and health of the feet. You can not walk for a long time in shoes with a narrow nose and high heels. It is advisable to use special orthopedic insoles prescribed by an orthopedist.

Try to reduce excess weight to normal and include foods with calcium in your diet to strengthen bones. If possible, it is better to avoid standing for a long time, 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 be with 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 the problems with the legs with an orthopedist who develops a full cycle of gymnastics for every day. Even the usual “bicycle” exercise, stretching the feet in different directions, away from you and towards yourself with the help of a towel, reduces the load on the arch. If you raise your legs up and just shake them well, you can get rid of edema, normalize blood flow. Take care of your feet!

Are there side spurs on the soles of the feet?

Vladimir Priorov

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

MuDaKoV.net Alexey

certainly))))))

Alena Khazova

According to the terminology used in medicine, the foot is the part of the leg located distally (remotely) from the center of the body. human is quite complex and ideally performs the tasks assigned to the feet.

foot anatomy

The main part of the functions is performed by the arches, due to which the depreciation occurs, which is required to protect other joints, including the spine, from excessive loads. The cuboid bone also plays an important role here.

The main elements of the foot are the bones of the skeleton, interconnected by joints, ligaments, tendons and muscles.

The role of the shock absorber is played by the arches of the feet - longitudinal and transverse. They are formed by bones, joints, muscles, tendons, making the leg flexible. Thanks to this structure, the load is distributed evenly between the first, fifth metatarsal bones and the heel.

The bone skeleton of the foot is formed from 3 sections:

tarsus (7 bones arranged in two rows);
metatarsus (5 short tubular bones);
phalanges are the smallest bones of the fingers.

You can independently feel where the cuboid bone is located, in simple terms - from the outside of the foot from the heel, it will be the first towards the phalanges of the fingers. This is a fairly dense bone mass, and it is extremely difficult to break it.

Tarsal bones

Tarsus - the widest part of the foot, consisting of the talus, calcaneus, navicular, lateral, intermediate, medial cuneiform and cuboid bones.

The talus, in other words, the calcaneus. The connection with the navicular bone occurs through the head. The posterior process consists of two tubercles with a tendon.
plays the role of a softener, a kind of springboard when moving. Despite the fact that this is the most massive formation, it is vulnerable and often damaged. According to the anatomy of the heel, it is located under the talus, with which they are connected by a short process. Through the tubercle, located behind the calcaneus, the lateral and medial processes depart from the surface of the foot.
Structural element of the tarsus, located in the inner edge of the foot. In the medial section, the concave lower surface is bumpy, palpable through the skin. The joints are reduced to the talus and cuboid bones, forming the arch of the foot.
The lateral bone is located in the upper outer part of the foot, it helps a person to make maneuvering movements while performing outward turns. The joint of the fibula connects to the lateral ankle surface of the talus.
The cuboid bone is located outside the lateral cuneiform bone, behind the base of the IV and V metatarsal bones and in front of the calcaneus.
The sphenoid bones of the foot are in front of the scaphoid.

Communication with the metatarsal bones is carried out due to the articular surface. Despite the fact that the cuboid bone is located in the region of the outer part of the foot, its fractures separately from the joint are quite rare. Among skeletal injuries, they account for 0.14%, foot bones - 2.5%.

Joint Features

The foot has a complex anatomical structure with a large number of joints that form two or more bones. The main joint is the ankle joint, consisting of the tibia and fibula, with lateral outgrowths and the talus.

This joint is responsible for the main function of the foot - its mobility, the rest provide the necessary elasticity and elasticity.

Intertarsal joints

due to the lateral processes (ankles), together with the talus, it forms a kind of block. Protection is provided by the articular bag and ligaments, so that the ankle joint can produce movements of the back and front flexion.
The subtalar joint is a less mobile articulation between the calcaneus and the talus.
The talocalcaneal-navicular joint is formed by the bones of the tarsus. A ligament connecting the calcaneus and talus passes through the cavities of these joints.
The calcaneocuboid joint is formed by the articular surfaces of the cuboid and calcaneus. The joint is strengthened by a common bifurcated ligament starting on the calcaneus.
The sphenoid joint is formed by the articular surfaces of the sphenoid and navicular bones.

Judging even by the photos offered on the Internet, the cuboid bone is well located in the joint and it is not easy to damage it. However, it is possible that if measures are not taken in time to provide surgical care, a person may begin to limp in one leg and even remain disabled.

The foot withstands serious static and dynamic loads due to the anatomical features of the structure and the presence of a large number of elastic elements.

Calcaneocuboid joint

It is located between the articular surfaces of the cuboid and calcaneus. Movements are carried out only in one direction, despite the fact that the joint is saddle. The capsule is attached to the edges of the articular cartilage and stretched tight. The articulation takes part in the movements of the previous joints and increases their amplitude. It is strengthened by the plantar, calcaneocuboid and long plantar ligament.

Together with the talocalcaneal-navicular articulation, it forms one transverse tarsal joint.

bone fracture

Other photos of the cuboid bone of the foot in case of a fracture are also required, so that there is no doubt about the diagnosis.

With a fracture, pain occurs when the foot turns in and out. Probing the localization of the injury brings severe discomfort. Treatment involves a circular plaster cast for 5 weeks. To fully restore working capacity, it is required to wear an arch support for a year after the fracture.

Injury occurs due to the fall of heavy objects on the leg or a direct blow. If it is present with subluxation, the defect becomes very noticeable, which depends on the debris and the degree of displacement. The arch of the foot is compacted, the forefoot deviates inward or outward.

After an injury, you can’t step on your foot and walk for the first week, later you can dose the load. For a complete restoration of motor functions, orthopedic shoes are worn throughout the year.

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

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

Anatomy

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

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

The cuboid bone is located at the outer edge of the foot between the bones of the metatarsus.

Causes and mechanisms

Fractures of the cuboid bone occur due to direct trauma, for example, a blow and a heavy object falling on the foot.

Symptoms

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

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

On palpation, exacerbation of pain occurs when touching all the bones of the site, with axial pressure on all toes.

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

Diagnostics

The final diagnosis is established after X-ray examination.

But at the same time should be remembered that there are additional bones: the peroneal epiphysis of the tuberosity of the V metatarsal bone (described by V. Gruber in 1885) is located in the corner between the cuboid and the V metatarsal bone, closer to its posterior surface.

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

First aid

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

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

In extreme cases, you can bandage the injured leg to a healthy one.

Treatment

Usually, cuboid fractures are not accompanied by severe displacement of fragments, as well as fractures of the sphenoid bones.

Therefore, the treatment is reduced to immobilization with a plaster bandage of the “boot” type, in the plantar part of which a metal arch support is built.

A plaster bandage is applied from the fingertips to the middle third of the lower leg 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, it is forbidden to walk, then a dosed load on the injured leg is allowed.

clinical picture.

Cuboid bone of the foot is part of the lateral column of the foot. It articulates with the lateral sphenoid, scaphoid, and calcaneus externally, distally with the lateral metatarsals. On the entire plantar surface, it takes part in the formation of the arch of the foot. It forms a groove for the tendon, therefore, 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 dorsum of the foot, a fracture of the cuboid bone can occur.

Indirect types of injury:

Nutcracker type damage. Compression damage to the cuboid bone that occurs during forced movement in the forefoot outward. The cuboid bone is crushed between the bases of the fourth and fifth metatarsal bones and the calcaneus.

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

Young athletes may experience stress fractures.

Carrying out diagnostics.

Clinical diagnostics. Patients complain of pain, as well as swelling along the inner-dorsal surface 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. Spend oblique, lateral and anteroposterior projection of the foot. A stress study is also carried out. Conducting oblique projections helps to additionally visualize the outlines of the articular surface of the cuboid bone itself.

Carrying out computed tomography. This is an additional way to visualize the fracture, it is carried out in the sagittal, frontal and axial projection. Helps to find out the features of the displacement of fragments during complex injuries.

Treatment of fractures of the cuboid bone of the foot.

Indications for conservative treatment.

Isolated injuries of the cuboid bone without signs of shortening and impression. The foot is fixed with a plaster splint for four to six weeks.

Operative treatment.

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

Fracture of the sphenoid bones.