Gregory Waryasz MD, Ashley Davidoff MD 

The Common Vein Copyright 2011

Definition

Fractures of the   are usually caused by axial loading and are often associated with occur with other tarsometatarsal injuries.

Isolated cuneiform fractures are uncommon.

Avulsion fractures can occur.

Displaced fractures and intracuneiform instability can occur in Lisfranc injuries.

The fracture may be complicated in the acute phase by neurovascular injury, or in the subacute or chronic phases by nonunion, malunion, infection, osteonecrosis, or osteoarthritis.

The diagnosis of this injury is usually made by a combination of physical examination and x-ray imaging.

Imaging includes the use of plain x-rays, and if indicated CT-scan, or MRI.

Isolated fractures of the cuneiforms without displacement can be treated when immobilization and non-weightbearing.

Surgery is indicated for Lisfranc injuries and injuries where there is displacement of the fracture fragments.

References

Davis MF, Davis PF, Ross DS. Expert Guide to Sports Medicine. ACP Series, 2005.

Elstrom J, Virkus W, Pankovich (eds), Handbook of Fractures (3rd edition), McGraw Hill, New York, NY, 2006.

Koval K, Zuckerman J (eds), Handbook of Fractures (3rd edition), Lippincott Williams & Wilkins, Philadelphia, PA, 2006.

Lieberman J (ed), AAOS Comprehensive Orthopaedic Review, American Academy of Orthopaedic Surgeons, 2008.

Moore K, Dalley A (eds), Clinically Oriented Anatomy (5th edition), Lippincott Williams & Wilkins, Philadelphia, PA, 2006.