A cuboid fracture is a break in the cuboid bone, one of the seven tarsal bones. It is located on the outer midfoot. This bone plays a key role in foot stability and helps support the lateral arch. Cuboid fractures are relatively rare, but when they do occur, they can affect mobility and weight-bearing function. Early diagnosis and management are essential to ensure good long-term outcomes.
Types of Cuboid Fractures and Mechanism of Injury
Cuboid fractures typically occur as part of a broader midfoot injury, but may also result from direct trauma to the outside of the foot. There are two main types:
- Avulsion fractures – small pieces of bone are pulled off by ligaments or tendons
- Compression or crush fractures occur when the cuboid is compressed between the heel and forefoot bones, often called a “nutcracker” fracture
Fractures may be isolated or associated with other foot injuries, particularly in high-energy trauma.
The Mechanism of Injury for Most Cuboid Fractures
Most cuboid fractures result from:
- Direct impact, such as a heavy object dropping on the foot
- Twisting or crush injuries, especially in car accidents or contact sports
- Forced plantarflexion with midfoot compression, commonly seen in equestrian or cycling injuries
- Occasionally, repetitive stress can cause a cuboid stress fracture, particularly in athletes or military recruits
The Symptoms of a Cuboid Fracture
Symptoms will change depending on the severity of the fracture, but often include:
- Pain on the outer side of the midfoot, especially with weight-bearing
- Swelling and bruising over the lateral foot
- Tenderness to touch over the cuboid bone
- Difficulty walking or limping
- In more severe injuries, loss of foot shape or arch support
Diagnosis of a Cuboid Fracture
Diagnosis involves a clinical examination and imaging:
- X-rays are usually the first step, but may not clearly show subtle or stress-related fractures
- CT scans are often used to assess displacement, joint involvement, and associated injuries
- MRI may be needed if a stress fracture or soft tissue injury is suspected
Early diagnosis is essential to prevent long-term foot instability or misalignment.
Access Ortho medical staff are skilled in diagnosing and treating cuboid fractures. They have fracture clinics located in Brisbane (Indooroopilly) and Ipswich.
Treatment Approaches for a Cuboid Fracture
Treatment will change depending on the type and severity of the fracture:
- Non-displaced fractures may be treated with a moon boot or cast and a period of modified weight-bearing
- Displaced or joint-involving fractures may require surgical fixation with screws or plates
- Rehabilitation includes a gradual return to weight-bearing and physiotherapy to restore strength and mobility
Your orthopaedic provider at Access Ortho will tailor the treatment plan based on imaging findings and functional needs.
Prognosis for a Cuboid Fracture
With timely and appropriate care, most cuboid fractures heal well. However, prognosis can vary depending on:
- The extent of displacement or joint involvement
- The presence of other foot injuries
- How rapidly the injury is diagnosed and treatment is started
Potential complications include chronic lateral foot pain, midfoot instability, or early arthritis if the injury is not well-managed.
Role of Access Ortho in Diagnosing and Treating Cuboid Fractures
At Access Ortho, we provide rapid assessment and imaging for foot injuries, including suspected cuboid fractures. Our experienced Nurse Practitioners and orthopaedic surgeons work collaboratively to:
- Identify and diagnose fractures with referral for X-ray and other scans if needed
- Provide moon boots, crutches, and pain management on the spot
- Provide follow-up care in our specialist orthopaedic clinics
If you’ve injured your foot, Access Ortho offers fast, expert care — no referral needed.