Isolated fracture-dislocation of the second cuneiform bone

Plantar Fracture-Dislocation of the Intermediate Cuneiform: Case Report

“…Rupture of the dorsal second metatarsal-intermediate cuneiform ligament probably is necessary to allow this deformation, especially with an associated fracture. 1,2,3,6,7,11,14 A review of the literature showed only three cases of plantar dislocation of the intermediate cuneiform reported previously 4,7,10 and all followed the application of a large force across the dorsum of the foot. The first was in a young man who had his foot crushed by a forklift and who required arthrodesis of the midfoot.…”

“…1 -4,6 -15 Dislocation of the intermediate cuneiform is the least common. 1,2,4,7,10,11,14 Dorsal dislocations of the cuneiforms are more common than plantar dislocations of the cuneiforms and usually are caused by axial loading and forced plantarflexion of the forefoot. Rupture of the dorsal second metatarsal-intermediate cuneiform ligament probably is necessary to allow this deformation, especially with an associated fracture.…”

“…12,14 Dorsal dislocation of the intermediate cuneiform occurs more commonly than plantar dislocation due to support from these plantar structures. 1,2,4,7,10,11,14 Diagnosis of these cuneiform dislocations was delayed because of unfamiliarity with radiographic appearances of the midfoot. 8,13 However, previously reported cases of plantar dislocation had been made at first presentation.…”

“…Reported outcome for cuneiform dislocation or subluxation diagnosed and treated early has been good. 1,4,7,8,10,15 Delayed treatment has resulted in poor outcomes. 8 However, even early diagnosis and treatment can lead to early radiographic changes consistent with arthritis.…”

An Isolated Dorsal Dislocation of the Lateral Cuneiform

“…3 From a literature review in PubMed, we found 23 articles about isolated fracturedislocations of the cuneiforms (medial, middle, lateral). Nine of these articles refer to isolated injuries of the medial cuneiform, 9,10,[12][13][14][15]19,22,26 10 of them to plantar fracture-dislocation of the middle cuneiform, 6,11,[16][17][18]20,21,[23][24][25] and the other 4 articles to fracture-dislocations of the lateral cuneiform. 4,5,7,8 From these 23 article, we have found only one article 7 about isolated dislocation, without a fracture, of the lateral cuneiform.…”