Dislocation of the calcaneocuboid joint presenting as lateral instability of the ankle

Abstract

A 16-year-old professional female ballet student sustained a plantar flexion-inversion injury to her left ankle while dancing. Clinical examination and MRI suggested subluxation of the tibiotalar joint. However, accurate diagnosis was hampered by a transient palsy of the common peroneal nerve. It was subsequently established that she had also sustained a dislocation of her calcaneocuboid joint, a rare injury, which was successfully stabilised by using a hamstring graft. The presentation and management of this rare condition are discussed.

Operative Technique for Cuboid Instability in an Elite Gymnast

“…18 Similar procedures have been performed using different grafts, such as the gracilis or peroneus brevis tendon. 23 Isolated dorsolateral calcaneocuboid ligament injury has also previously been treated by arthrodesis. This type of procedure, however, runs the risk of reducing mobility of the lateral foot column, thereby increasing the force transmitted through neighboring joints and altering biomechanics.…”

“…Previous methods of operative repair described in the literature include arthrodesis, reconstruction using gracilis, plantaris or peroneus brevis tendons, and periosteal flap repair. 23 In this case report, we outline a previously unreported method of operative fixation performed in an elite gymnast, including the radiologic imaging that led to this clinical decision.…”

Transverse Tarsal and Tarsometatarsal Cuboid Subluxation: A Case Report

“…Hence, subluxations and dislocations of the joint are rare with only few reported cases. The condition has been reported in association with Ehler-Danlos syndrome, 4 ballet dancing, 3,8 and trauma. 1–2,5–7 Diagnosis is difficult and requires clinical suspicion and careful examination of routine radiographs supplemented by stress radiography 9 or computed tomography.…”

“…The direction of displacement of the cuboid has been reported as plantar and medial. Plantarflexion-inversion, 8 abduction 1 and pronation injuries 3 have been the mechanisms ascribed to plantar-medial cuboid subluxation. The orientation and morphology of the cuboid tarsometatarsal joint with lateral coverage of the distal end of the cuboid by the base of the fifth metatarsal and the restraint provided by the peroneus longus tendon are likely factors against lateral subluxation and abduction of the cuboid.…”

“…Cuboid subluxations and dislocations are rare foot injuries with only a few reported cases. 1–8 Wherever described, the displacement of the cuboid has been in a plantar and medial direction. 1–2,5–6 We describe a case with late presentation of cuboid subluxation with plantar displacement, abduction and supination of the cuboid with fracture of the base of fourth and fifth metatarsals.…”