Tarsal Fracture

Aka: Tarsal Fracture, Cuboid Fracture, Cuneiform Fracture

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II. Epidemiology

  1. Midfoot, Tarsal Fractures are the least common Foot Fractures
    1. Strong mesh of ligamentous structures stabilize the midfoot and tarsal bones

III. Mechanism

  1. See Lisfranc Fracture
  2. See Tarsal Navicular Fracture
  3. See Tarsal Navicular Stress Fracture
  4. Cuboid Fracture
    1. Direct Trauma or crush injury
    2. Torsional force at midfoot
  5. Cuboid Fracture
    1. Crush injury from forced foot abduction (nutcracker Fracture)
    2. Chip Fractures, on the other hand, are minor Fractures by comparison

IV. Imaging: XRay in Cuboid or Cuneiform Fracture

  1. Weight-Bearing Three View Foot XRay (AP, Lateral and oblique)
    1. Repeat XRays every 2 weeks

V. Management

  1. See Lisfranc Fracture
  2. See Tarsal Navicular Fracture
  3. See Tarsal Navicular Stress Fracture
  4. Cuboid or Cuneiform Fracture
    1. Initial
      1. Short Leg Walking Cast or boot for 6 weeks
      2. Weight bearing as tolerated
    2. Next
      1. Hard soled shoe (or arch support with Orthotic) for another 6 weeks
    3. Orthopedic or podiatry referral indications
      1. Comminuted ot significantly displaced Fracture
      2. Fracture AND dislocation

VI. Complications

  1. Peroneus longus tendon dysfunction
    1. Secondary to scar formation with Cuboid or Cuneiform healing

VII. References

  1. Silver (2024) Am Fam Physician 109(2): 119-29 [PubMed]

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