Lag screw fixation of simple cuboid fracture

The goal of the treatment is bone healing with appropriate intra- and extraarticular reduction to maintain lateral column length.

The calcaneocuboid joint and the talonavicular joints are responsible for complex hindfoot circumduction.

Lateral column length is critical to maintaining the shape and function of the foot. Therefore, the cuboid length must be maintained.

Irrigate and debride the fracture site using a syringe or a curette.

Reduce the fracture using small pointed reduction forceps.

Insert two K-wires to secure the reduction.

If cannulated screws are used, the guide wires can be used for provisional fixation.

If solid screws are to be used, be sure to place the K-wires so that they will not interfere with the subsequent screw placement.

Given the cuboid’s shape, the choice of screw trajectory is limited, and it may not be possible to insert the lag screw perpendicular to the fracture plane.

These fractures can be fixed with crossing screws, usually from distal to proximal.

Following the standard technique, insert two screws into the planned screw trajectory.

• Insertion of cortical lag screws

They may be non-cannulated, cannulated, or headless compression screws.

In contrast to lag screws inserted in the diaphysis, these lag screws will typically not penetrate the far cortex, as this would damage the opposite articular surface. Screw holes should be countersunk to prevent prominent hardware and interference with applying a neutralization plate.

Do not fully tighten the lag screws.