Ohmori Takaaki, Katsuo Shinichi, Sunayama Chiaki, Mizuno Katsunori, Ojima Tomohiro, Yamakado Kotaro, Ando Tomonari, Watanabe Shin, Hayashi Seigaku, Tsuchiya Hiroyuki
Department of Orthopedic Surgery, Fukui General Hospital, 58-16-1 Egami, Fukui, Fukui 910-8561, Japan; Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University, Takaramachi 13-1, Kanazawa, Ishikawa 920-8641, Japan.
Department of Orthopedic Surgery, Fukui General Hospital, 58-16-1 Egami, Fukui, Fukui 910-8561, Japan.
Case Rep Orthop. 2016;2016:3264172. doi: 10.1155/2016/3264172. Epub 2016 May 26.
Isolated cuboid fractures are very rare, since they typically occur in combination with midfoot fractures or dislocations. A 61-year-old man presented at our hospital with pain and swelling on the outside of his right foot. The lateral column of his right foot was shortened by approximately 6.5 mm on X-ray. CT showed displacement of the joint surface between the cuboid and the fourth metatarsal, with a 3.5 mm depression. An MRI revealed no other injuries. Based on these findings, we diagnosed the patient with an isolated nutcracker fracture of the cuboid. Using a 1.9 mm arthroscope, we examined the Lisfranc joint. Then the depressed fragments were elevated until the regular joint line was restored. A bone biopsy needle was then used to fill in the large defect with artificial bone. In this case, we did not plate the fracture. Six months after surgery, patient could walk without pain. We report a very rare case of isolated nutcracker fracture of the cuboid. In addition, we suggest our new treatment plan of this fracture.
孤立性骰骨骨折非常罕见，因为它们通常与中足骨折或脱位合并发生。一名61岁男性因右足外侧疼痛和肿胀前来我院就诊。X线显示其右足外侧柱缩短约6.5毫米。CT显示骰骨与第四跖骨之间的关节面移位，并有3.5毫米的凹陷。MRI显示无其他损伤。基于这些发现，我们诊断该患者为孤立性骰骨胡桃夹骨折。使用1.9毫米关节镜检查了Lisfranc关节。然后将凹陷的骨折块抬起，直到恢复正常的关节线。接着用骨活检针用人造骨填充大的缺损。在这种情况下，我们没有对骨折进行钢板固定。术后六个月，患者能够无痛行走。我们报告了一例非常罕见的孤立性骰骨胡桃夹骨折病例。此外，我们提出了这种骨折的新治疗方案。
