posted last week about my fracture of cuboid bone on 10/13. on 10/23 mri was read by first radiologist said it was a stress reaction. per podiatrist - second radiologist looked at mri and said it was a non-displaced cuboid fracture. yesterday was 7 weeks from the fracture and 6 weeks in the boot and i have been incredibly compliant and even used a bone growth stimulator for about 3 weeks (bought on ebay - ran out of batteries - can’t replace). had mri this morning and results came back as “persistent nondisplaced fracture of cuboid. degree of marrow edema has improved only slightly since prior examination”.
is this normal - 7 weeks out and only slight healing?
i thought 7 weeks in a boot with 3 weeks of bone growth stimulator would really work well
don’t see dr. until thursday. any idea what comes next.
am i jumping the gun thinking 7 weeks is too early?
5 the boot is just so incredibly annoying. all i’ve done is swim without touching the wall and some aqua jogging.
should i be panicking yet (though i think i am) ? what is the average time for a slight fracture of the cuboid should heal?
Not a doc but some first hand and familial experience with foot fx and other bone injury in areas with low blood supply (similar to cuboid)- I think you may be expecting too much too soon. With limited blood flow, healing is not going to be rapid. The boot is not magic, just wearing it does not come anywhere near fully eliminating forces on the bone. It’s a compromise. And bone stimulators provide a possible boost but also are not magic, they do not shoot healing rays, they just stress the bone gently (ie with no load or impact) in hopes of urging it to do what it does naturally a little faster. If you’re already inadvertently stressing the bone through the boot (not saying you are), the stimulator isn’t going to help.
Metatarsals, scaphoid/navicular, cuboid - they are all at risk for non-union even if you do everything exactly the way you are supposed to. Your goal should not be to get back in action fast, it should be to avoid surgery. That can mean being beyond incredibly compliant.
This site indicates stress (not to mention full) fracture of cuboid can take 3-6 months and as much as a year:
You need to talk to your doctor, not us. All we can do is tell you is to be patient. If I had to guess, your doc will probably be willing to wait a little longer to see if it will heal on its own. But they won’t wait forever, nor do you want them to.
Yes, cuboid stress fractures (or occult fractures) are pretty slow healers (like the navicular or scaphoid in the wrist). MIN time to heal about any fx would be 6 weeks, so you are on the low end of things at 7. Figure more like 12 or more. If you think the “boot is incredibly annoying”, many advocate below the knee total cast immobilization for 6 weeks…
thanks RRoof. so if the MRI of today shows minimal healing - does that mean that these 7 weeks were all for naught? that the clock has to start all over? if you’re saying 6 weeks is on the low end, i feel kind of better as long as i have those weeks in the bank . . . . . . . are they?
Too many variables (i.e. L vs R (driving), work requirements, “A” race timeline, DVT/blood clot risk, etc.) - best to discuss with your treating physician!
I’m actually going this right now with a very good (national caliber) duathlete with a calcaneal stress fx we just can’t get healed with a million variables (89 lbs amenorrheic, thyroid issues, vegan since age 14, etc.) Ugh.
dr. roof-
I see doctor tomorrow but I was wondering about the question of time and healing? because there is minimal healing, does this mean that the healing time starts all over again or maybe there can be a spike in healing soon? are these 8 weeks lost?
thanks
Here’s the latest. Saw Dr. said 4-6 weeks now 100% non-weight bearing. rented knee scooter - crutches suck. he suggested ct scan to see more what is going in. ct scan came back with:
*there is healing intra-articular fracture of distal lateral cuboid with extension to the 4th and 5th tarsometatarsal joints, with only minimal articular surface step off, less than 1 mm. there is no significant lucency along the fracture margins to suggest nonunion. Mile amount of sclerosis is seen along the fracture margins compatible with healing callus. *
I see there is healing but it doesn’t say how much or how far along the healing is. unless it says so and I am not interpreting the language correctly.
podiatrist said 4-6 weeks non-weight bearing still. do you guys concur?
it’s been 8 weeks now in the boot. been about 98% non-weight bearing for 4 days with a fee exceptions (getting in shower, etc.) do you think I need a hard cast to enable this non-weight bearing further or is the boot sufficient.
thanks for your opinion. good to have someone else’s ideas.
Here’s the latest. Saw Dr. said 4-6 weeks now 100% non-weight bearing. rented knee scooter - crutches suck. he suggested ct scan to see more what is going in. ct scan came back with:
*there is healing intra-articular fracture of distal lateral cuboid with extension to the 4th and 5th tarsometatarsal joints, with only minimal articular surface step off, less than 1 mm. there is no significant lucency along the fracture margins to suggest nonunion. Mile amount of sclerosis is seen along the fracture margins compatible with healing callus. *
I see there is healing but it doesn’t say how much or how far along the healing is. unless it says so and I am not interpreting the language correctly.
podiatrist said 4-6 weeks non-weight bearing still. do you guys concur?
it’s been 8 weeks now in the boot. been about 98% non-weight bearing for 4 days with a fee exceptions (getting in shower, etc.) do you think I need a hard cast to enable this non-weight bearing further or is the boot sufficient.
thanks for your opinion. good to have someone else’s ideas.
“how much or how far along” fracture healing is not possible (well, 100% I guess would be reported). I’d suggest a below knee fiberglass cast (esp since I don’t trust type-A triathletes, no matter how good they say they are)
I am curious how this turned out. Here is my situation - I am at week 7 after turning my foot over, back in a boot.
First Opinion - Diagnosed as fracture 2 days after it happened - 2 Weeks in Boot (ok to cycle/swim (no push-off))
Did 2 Weeks in Boot (cycle/swim (no push-off))
Second Opinion at end of week 2 - not a fracture 3 weeks in brace + physical therapy (ok to cycle/swim (no push-off)) ( When I went for 2nd Opinion, I was ok to stay in the boot to be safe, but wanted to know if I should completely cut out swim/cycle - so I was a bit surprised at the no break)
Did 3 weeks in brace + physical therapy (cycle/swim (no push-off))
Steroid shot at week 3.5 - Dr thought it is just discomfort at the joint, therefore just inflammation
Week 5, Dr tells me I need to try running to see how it feels (I was hesitant)
I did 4 runs over a few days as suggested, felt good, just stiff when restart after start - NO REAL PAIN - almost felt like the shoe was tied a bit tight, but that was it
Now at week 5.5, Dr says we can do MRI just to confirm all is well (not sure why we did not do this before running) and MRI comes back positive for fracture
Dr says back in boot for 4 more weeks + bone growth stimulator (of course, no running, but still, ok to cycle/swim (no push-off))
Today I am at week 7, with 3 days on the simulator.
Here is what I am looking at - really really don’t want to lose IMAZ…
Races:
IMTX - late April - skipping IMTX in 2 weeks,
IMCDA - late June - all arrangements made for IMCDA (if ok at week 4, then only 7 weeks to IMCDA, so planning to move it Boulder in August to buy ~6 more weeks, hoping foot heals at some point)
IMAZ - mid November - A race; don’t want to skip