Fracture of the lateral cuneiform only: a rare foot injury

The three (medial, intermediate, and lateral) cuneiforms and their articulations in the foot are small and relatively well protected from injury. An isolated fracture of the lateral cuneiform is a rare finding. However, isolated injuries may occur as the result of direct trauma. We report a case of an isolated fracture of the lateral cuneiform that was not seen on initial radiographs and only became evident on plain radiographs 4 weeks after the injury. As each of the cuneiform bones articulates with four other bones in the midpart of the foot, persistent displacement of any fracture (subluxation or dislocation) may result in post-traumatic arthritis. We believe that in suspected cases with negative radiographic findings, further imaging (computed tomography or bone scanning) should be requested. Without the use of additional imaging techniques, many fractures may be misdiagnosed as ankle sprains or foot contusions, and patients may be discharged from the hospital.