A Case Report of Isolated Cuboid Nutcracker Fracture.

Isolated cuboid fractures are very rare, since they typically occur in combination with midfoot fractures or dislocations. A 61-year-old man presented at our hospital with pain and swelling on the outside of his right foot. The lateral column of his right foot was shortened by approximately 6.5 mm on X-ray. CT showed displacement of the joint surface between the cuboid and the fourth metatarsal, with a 3.5 mm depression. An MRI revealed no other injuries. Based on these findings, we diagnosed the patient with an isolated nutcracker fracture of the cuboid. Using a 1.9 mm arthroscope, we examined the Lisfranc joint. Then the depressed fragments were elevated until the regular joint line was restored. A bone biopsy needle was then used to fill in the large defect with artificial bone. In this case, we did not plate the fracture. Six months after surgery, patient could walk without pain. We report a very rare case of isolated nutcracker fracture of the cuboid. In addition, we suggest our new treatment plan of this fracture.

Irreducible plantar dislocation of the interphalangeal joint of the great toe due to an accessory sesamoid bone: a case report.

INTRODUCTION: Great toe dislocation frequently occurs at the metatarsophalangeal joint. However, an irreducible dislocation of the great toe interphalangeal (IP) joint due to an accessory sesamoid bone is relatively unusual. CASE REPORT: A 23-year-old woman suffered a dislocated IP joint of the left great toe. The distal phalanx was plantar subluxated, and the articular surface was misaligned. Ultrasound, magnetic resonance imaging, and computed tomography images did not indicate any factors inhibiting reduction. In addition, the sesamoid bone at the IP joint was found to be rotated in the long-axis direction. The sesamoid bone of the IP joint was hooked from the distal direction and occupied the intercondylar area. IP joint of the left great toe was flexed and the distal phalanx was pushed toward the proximal phalanx during reduction locking with fluoroscopic guidance under local anesthesia, and the dislocation was successfully reduced. DISCUSSION: The sesamoid bone at the IP joint is anatomically located dorsal to the flexor hallucis longus tendon and volar plate. The sesamoid bone fitted exactly in the distal intercondylar area. The sesamoid bone in our patient could be rotated by forcible plantar flexion of the IP joint displaced proximally and hooked into the intercondylar area from the proximal aspect. Then, the distal phalanx was pulled proximally through the volar plate. This is the first report on a plantar dislocation of the IP joint.