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Nondisplaced cuboid fracture

by L
(Pa)

Good morning!

Last weekend I had the bright idea to stand on top of a plastic 5 gallon bucket to quickly get a better vantage point. My left foot fell through the plastic lid and my ankle rolled with the majority of my weight landing on the outside of the foot. I immediately had pain that took my breath away as well as a golf ball size lump on the side of my foot. I was able to walk but with segnificant pain however 30 minutes later I was unable to walk at all. My entire foot swelled and I had segnificant pain on the left side of my foot as well as the arch of my foot.

The following day I had an appointment with an orthopedic to have the foot looked at. Nothing showed up on the x-rays but I presented with what was assumed as a nondisplaced cuboid fracture.. The ortho sent me home on crutches and told me to be partial weight bearing. The only thing is I can't bear much weight if any. I was sent for an MRI on Wednesday of this week and was not scheduled for a follow up for an additional 2 weeks. I called today for the results of the MRI as I was not waiting 2 weeks to find out what was wrong. The nurse confirmed that it was indeed a nondisplaced cuboid fracture of the foot and per the Doctor I am supposed to use crutches for comfort and bear weight as tolerated. As well as return in 2 weeks for a follow up. My foot is not in a cast, walking boot or any sort of protective device which is concerning to me based on all the research I've done on this injury. As well as the fact that I have a toddler and dog that seem to bump it at every opportunity they get.

Per the research I've seen all treatment o. The foot had been either casted or a walking boot as well as non weight bearing for a number of weeks and most were having prolonged healing issues. My questions and concerns are in regards to the way I'm currently being treated for this injury. I am fearful of not healing and or prolonging the healing process.

1. Is it common to not treat this kind of injury with anything other than crutches? Should ! be putting any weight on the freactured foot? Shouldn't it be protected as well as not putting any weight on the fractured portion of the foot?

2. Can the nondisplaced fracture become a displaced fracture by bearing weight?

3. My foot is still swollen and tends to get tingly and cold. I still have pain at the arch. The whole foot just feels tired.
The tingles and cold foot are concerning to me.

4.i am thinking about getting a second opinion on treatment. Is it too soon to seek another opinion?

Thank you so much for taking the time to read this. I appreciate any information you are able to pass along to me.

RESPONSE

Hi,

In general if you have a non-displaced fracture of a bone, it just means there is a crack in the bone and all things being equal, it should heal.
You evidently are young and assuming you are not diabetic and do not smoke, there is very little reason to assume there will be an issue.
The best way to treat a fracture of the foot is to stay non-weightbearing. If you do not bear weight on the foot, you do not run the risk of disrupting the break.
Whether or not you wear some sort of cast is kind of up to you. On the plus side, the foot is better protected so when your child or dog step on your foot, there is less chance of doing damage. The downside is that a cast is heavy and may make it more difficult to stay non-weightbearing.
Given the choice between having a patient non-weightbearing without a cast versus someone bearing some weight and wearing a cast, I would opt for non-weightbearing every time.
The problem for many people is that they cannot go non-weightbearing usually because of job requirements.
So if you are fortunate enough that you can stay non-weightbearing, I would opt for that treatment.
The tingly and cold sensations are a little bit of a concern to me.
If they persist, you would need to have Complex Regional Pain Syndrome rule out. You can read about CRPS on this site.

Marc Mitnick DPM
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