title: The patterns of injury and management of cuboid fractures: a retrospective case series.
abstract: OBJECTIVE
  Although infrequent, a fracture of the cuboid can lead to significant disruption of the integrity of the midfoot and its function. The purpose of this study was to classify the pattern of fractures of the cuboid, relate them to the mechanism of injury and suggest methods of managing them.
  
  
  METHODS
  We performed a retrospective review of patients with radiologically reported cuboid fractures. Fractures were grouped according to commonly occurring patterns of injury. A total of 192 fractures in 188 patients were included. They were classified into five patterns of injury.
  
  
  RESULTS
  Type 1 fractures (93 fractures, 48.4%) are simple avulsion injuries involving the capsule of the calcaneo-cuboid joint. Type 2 fractures (25 fractures, 13%) are isolated extra-articular injuries involving the body of the cuboid. Type 3 injuries (13 factures, 6.8%) are intra-articular fractures solely within the body of the cuboid. Type 4 fractures (35 fractures, 18.2%) are associated with disruption of the midfoot and tarsometatarsal injuries. Type 5 fractures (26 fractures, 13.5%) occur in conjunction with disruption of the mid-tarsal joint and either crushing of the lateral column alone or of both medial and lateral columns. Fractures with significant articular disruption or with loss of length of the lateral column underwent fixation. This involved either internal fixation to restore the anatomy of the cuboid and/or restoration of the length of the columns with bridging constructs using internal or external fixation.
  
  
  CONCLUSIONS
  A classification system for fractures of the cuboid is proposed in relation to the mechanism of injury. The treatment of these fractures is described. Cite this article: Bone Joint J 2016;98-B:1003-8.
authors.affiliation: Queen Elizabeth Hospital, Mindelson Way, Birmingham, B15 2 GW, UK.
authors.forename: P
authors.initials: P
authors.lastname: Fenton
authors.affiliation: The Ipswich Hospital , Heath Road, Ipswich, IP4 5PD, UK.
authors.forename: S
authors.initials: S
authors.lastname: Al-Nammari
authors.affiliation: Northern General Hospital, Herries Road Sheffield, S5 7AU, UK.
authors.forename: C
authors.initials: C
authors.lastname: Blundell
authors.affiliation: Northern General Hospital, Herries Road Sheffield, S5 7AU, UK.
authors.forename: M
authors.initials: M
authors.lastname: Davies
mesh_terms: D005593:Fracture Fixation, Internal; D050723:Fractures, Bone / Q000145:classification* / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D012189:Retrospective Studies; D013639:Tarsal Bones / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D014193:Trauma Centers
keywords: Cuboid; Fracture; Midfoot