Weber Martin, Locher Siegfried
Department of Orthopaedic Surgery, University of Bern, Inselspital, Switzerland.
Foot Ankle Int. 2002 Nov;23(11):1008-13. doi: 10.1177/107110070202301107.
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.
骰骨压缩性骨折是罕见的损伤，通常与中足内侧骨折或脱位合并发生。在三年期间，我们机构对12例骰骨骨折患者进行了手术治疗。11例患者累及跗跖关节4和5，4例累及跟骰关节，3例同时累及近端和远端关节。5例患者的外侧柱缩短。使用撑开式外固定器有助于切开复位。7例患者需要取自体髂骨皮质松质骨移植。8例患者采用单钢板或双钢板固定，4例患者仅采用螺钉固定。随访时间为12至47个月。在恢复长度、重建关节面和总体功能恢复方面结果良好。4个受伤的跟骰关节中有1个出现轻微残留症状，跗跖关节4的11个关节中无一出现残留症状，跗跖关节5的11个关节中有2个出现残留症状。更常见且更严重的症状源于相关的中足损伤。通过包括切开复位和内固定在内的积极即时治疗，可有效预防骰骨压缩性骨折导致的畸形和残疾。
