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The response to the question below was authored by Marc Mitnick DPM
non displaced cuboid fracture - 7 weeks not healing
twisted foot running on 10/13. went to ER as was in great pain. xrays negative for fracture. week later went to podiatrist still in pain and got mri. radiologist said stress reaction but podiatrist thought he saw something. radiologist amended his report to say nondisplaced fracture of cuboid bone. in walking aircast boot for 7 weeks. all i've done is swim without pushing off wall and some aqua jogging. got bone stimulator off of ebay and used for 3 weeks (ran out of batteries and can no longer use). yesterday was 7 weeks since fracture 6 weeks in boot. had another mri and it said "persistent nondisplaced fracture of cuboid degree of marrow edema has improved only slightly since prior examination.
is this normal to not heal by 7 weeks since incident?
shouldn't there be some healing?
what is next step?
how much longer can i expect it to be healed?
i'm an avid runner and being in the boot is killing me. no way did i expect the mri to show non-healing
thanks for any help
I am going to go out on a limb and guess since you are an avid athlete that you are in good health and are a non-smoker. It would be nice to know how old you are.
One would think that a possible fracture in an otherwise healthy individual would be healed by now.
I am not sure I like the idea that you were swimming and doing water exercise during this time, nor do I think the bone stimulator you bought on Ebay did you any good.
What we know from the MRI is that you might have a fracture. Reactive marrow edema is suggestive of a fracture but not definitive and since there is no real "crack" in the bone, we cannot be certain there is actually a break in the cuboid bone.
You might be dealing with a subluxed cuboid that has not "popped" back into place and that too may explain why you still have pain. An MRI is not very good at finding a displaced cuboid; a CT scan is usually better.
If you were my patient I would approach the problem this way: I would order a bone scan. If it comes back "hot" than you can assume fracture; if it does not, you may be dealing with a subluxed cuboid. (all this assumes the MRI was negative for any soft tissue damage in the surrounding area).
Quite frankly you are correct in your assumption that a possible crack in the bone should be healed by now in an otherwise healthy individual.
So, if the bone scan comes back hot then we can assume a fracture and in that case you will have to remain immobilized, but in addition I would recommend getting a real bone stimulator through your doctor; most insurances will cover them seven weeks post trauma.
If the bone scan comes back negative and there is no problems with the surrounding soft tissue, via MRI, then I would be leaning more towards a subluxed cuboid. At this point I would see about manipulating it back into place.
Hope this is helpful.
Marc Mitnick DPM
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