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Injury Patterns, In-Hospital Outcomes, and Resource Utilization of Acute Cuboid and Navicular Fractures
Daniel Liu1, Puranjay Gupta1, Jamal Ahmad2
1University of Illinois Chicago, College of Medicine, 1853 W. Polk Street, Chicago, IL, 60612.
Background:
Acute cuboid and navicular fractures can be serious injuries. However, multicenter data on their associated injuries and in-hospital course are limited.
Purpose:
To characterize the demographics, injury patterns, in-hospital outcomes, and resource utilization of trauma center patients with acute cuboid and/or navicular fractures.
Study Design:
Retrospective cross-sectional database study.
Methods:
The American College of Surgeons National Trauma Data Bank (2017-2019) was queried for acute cuboid and/or navicular fractures. Multivariable regression identified factors associated with discharge to post-acute care, intensive care unit (ICU) admission, and hospital length of stay in adults.
Results:
Overall, 3,424 patients with 4,084 fractures were identified (2,327 with cuboid and 1,637 with navicular fractures, including 540 with both). Road-traffic mechanisms accounted for 64.5%, and 25.1% had polytrauma. Metatarsal, calcaneal, and talar fractures were the most common concomitant injuries. Combined fractures were more often ipsilateral than contralateral (457 vs 18 patients). Despite infrequent complications, 50.2% were discharged home without post-acute services (home health, inpatient rehabilitation, or skilled nursing care). In-hospital mortality was 1.1%. After adjustment, polytrauma (OR 3.75, 95% CI 3.04-4.61), bilateral involvement, and ankle, tibia, fibula, or metatarsal fractures were associated with discharge to post-acute care, whereas fracture pattern was not.
Conclusions:
Cuboid and navicular fractures are predominantly high-energy injuries that rarely occur in isolation. Post-acute care needs, ICU admission, and length of stay were associated with overall injury burden rather than the specific bone fractured.
