The cuboid bone is one of three bones that make up the mid foot. A cuboid bone fracture is, as the name suggests, a break of the cuboid bone. Casting or otherwise immobilizing the foot and ankle usually is the treatment for this type of injury.

The cuneiform, cuboid and navicular bones make up the mid portion of the human foot. These three bones are situated between the metatarsals, which are the bones in the top of the foot, and the calcaneus, or heel bone. A cuboid bone fracture is sometimes referred to as a “nutcracker fracture” because the cuboid bone is often cracked between the fourth and fifth metatarsal bones of the foot and the heel bone, resembling a nut being cracked between the prongs in a nutcracker.

This type of fracture usually is not an isolated injury. Typically, a break of the cuboid bone is accompanied by fractures to other bones in the foot or some type of injury to the tendons or ligaments of the foot or ankle. Isolated cuboid bone fractures usually are caused by a direct trauma to that area of the foot. More often, these types of fractures occur when the foot or ankle is forcibly twisted outward, which tends to cause related injuries in the foot and ankle area.

Pain, tenderness and bruising along the lateral — or outer — side of the foot are symptoms that are commonly associated with cuboid bone fractures. The most common symptom of a cuboid bone fracture is an inability to bear weight on the injured foot. In some cases where multiple injuries are present, the foot can become deformed.

Typically, a basic X-ray is used to diagnose a cuboid bone fracture. It also is common for physicians to order a computed tomography (CT) scan of the injured foot. Doctors use the CT scan to better determine the full extent of the injury and to check for any additional injuries.

Treatment of a cuboid bone fracture generally depends on the severity of the fracture, the type of fracture and any additional injuries that might be present. A cast or immobilization brace is often used to give the foot time to heal. Most of the time, the healing process takes four to six weeks.

In rare cases, more aggressive treatment is needed to care for this type of injury. In cases of severe fractures, dislocations or displacements of the cuboid bone or the presence of other injuries, surgery or reduction procedures might be required. An open reduction, internal fixation (ORIF) is used to re-set dislocated or displaced bones. Surgery is reserved for more extreme cases, often when tendons or ligaments are injured and need repair. Both of these types of procedures are often followed by a period of immobilization in a cast or brace and physical therapy to regain proper function and strength.