Reconstruction of the cuboid in compression fractures: short to midterm results in 12 patients.

Cuboid compression fractures are rare injuries, usually occurring in combination with medial midfoot fractures or dislocations. During a three year period 12 patients with cuboid fractures were operatively treated at our institution. Eleven patients had involvement of the tarsometatarsal 4 and 5 joints, four of the calcaneocuboid joint, and three of both the proximal and distal joints. The lateral column was shortened in five patients. Open reduction was facilitated using a distracting external fixator. Iliac crest corticocancellous grafts were necessary in seven patients. Single or double plate fixation was performed in eight, screw fixation alone in four patients. Follow-up ranged from 12 to 47 months. Results were good with respect to restoration of length, reconstruction of the joint facets and overall return to function. Minor residual symptoms were noted in one (of four) injured calcaneocuboid joints, in none (of 11) of the tarsometatarsal joints 4 and in two (of 11) of the tarsometatarsal joints 5. More frequently and to a greater extent symptoms arose from the associated midfoot injuries. Deformity and disability from cuboid compression fractures can effectively be prevented by immediate aggressive treatment consisting of open reduction and internal fixation.