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Clinical Outcomes of Avulsion Fractures of the Cuboid and Navicular After Supination Trauma
Maarten P Cornelissen1, Mirte I Muntel1, Pieter B A A Van Driel1
1Department of Orthopedic Surgery, Isala Clinics, Zwolle, The Netherlands.
Abstract:
Supination trauma-related avulsion fractures of the foot are seen frequently, with cuboid and navicular fractures being among the most frequent types encountered. Nevertheless, the prognosis of these fractures remains largely unknown. This study was conducted to evaluate the clinical outcomes of the 2 most prevalent avulsion fractures-cuboid and navicular. A retrospective cohort consisting of patients who sustained a cuboid or navicular avulsion fracture after supination trauma between 2017 and 2020 was compiled and baseline characteristics along with retrospective data were collected. To gain data on clinical outcome 2 questionnaires, the Numerical Rating Scale (NRS) for pain and the Foot and Ankle Ability Measure (FAAM), were completed by participants 2 to 5 years after the fracture. Thirty-seven participants consented to participate, 25 experienced a cuboid fracture and 12 a navicular fracture. Cuboid fracture patients had a median week-average NRS score of 0 (range 0-7) and a median FAAM score of 105 (range 62-116), on average 40.8 months (SD 7.74) after treatment. Five out of 25 (21%) patients experienced persisting foot pain (NRS of ≥2). Navicular fracture patients had a median week-average NRS score of 1.5 (range 0-5) and a median FAAM score of 104 (range 55-116), a median 37.25 (range 27-47) months after treatment. Five out of 12 (42%) patients had a persisting NRS score of ≥2. Avulsion fractures of the cuboid and navicular bones generally have a favorable clinical outcome. However, a substantial portion of patients with both fracture types experienced persistent foot pain ≥24 months after the fracture.Levels of Evidence: Level II: Retrospective cohort study with prospective follow-up design.
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