Cuboid fractures due to the particular bone anatomy and its protected location in the midfoot are rare, and they are usually associated with complex injuries of the foot. Clinical examination to diagnose these fractures should be detailed and the differential diagnosis, especially in the case of vague symptoms, should include the exclusion of all lateral foot pain causes. Conventional radiographs do not always reveal occult fractures, which can be under diagnosed especially in children. In this case, further investigation including magnetic resonance imaging or scintigraphy may be required. The treatment of these injuries depends on the particular fracture characteristics. Non-displaced isolated fractures of the cuboid bone can be effectively treated conservatively by immobilization and by avoiding weight bearing on the injured leg. In the case of shortening of the lateral column > 3 mm or articular displacement > 1 mm, surgical management of the fracture is mandatory in order to avoid negative biomechanical and functional consequences for the foot and adverse effects such as arthritis and stiffness as well as painful gait. In this review, an update on diagnosis and management of cuboid fractures is presented.
Osteoporosis is a common disease in the elderly, correlated with increased fracture risk, disability and mortality. Bisphosphonates are efficient and have been widely used in the treatment of osteoporosis. Nevertheless, long term bisphosphonate use has been linked with atypical femur fractures. These have a characteristic pattern and history. They usually occur in the proximal third of the femur, and may be complete or incomplete, manifesting either like a radiolucent line or just thickening of the lateral cortex. Their morphology is simple, transverse or short oblique. They are related to minimal, or no trauma at all, but symptoms do pre-exist long before the gross fracture actually takes place.In this paper we report the case of a 75-year-old woman who sustained an atypical right femur fracture while walking. Her past medical history of osteoporosis treated with alendronate for six years along with symptoms in the contra-lateral thigh for the past 2 years, lead to imaging of the left femur. Thus, our patient had a complete fracture on the right side and an incomplete one, represented by lateral cortex thickening on the left. Treatment consisted of discontinuation of bisphosphonates, intra-medullary nailing of the right femur and conservative treatment of the left side. Uneventful union occurred on both sides.
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Young patient exhibiting lumbar pain accompanied by severe kyphoscoliosis‐hemivertebra of the thoracolumbar spine; a rare etiology with difficult surgical treatment.
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