NON-OPERATIVE MANAGEMENT FOR A NON-UNION CUBOID FRACTURE

The authors describe the case of a 30-year-old female who presented with right foot pain after a trampoline injury. She was diagnosed with a closed, slightly displaced avulsion fracture of the right cuboid and was managed conservatively. Initial conservative management failed, however after two months of continued electrical bone stimulation and immobilization, bony union with osseous bridging was apparent on imaging. The patient was able to avoid surgery and began a rehabilitation program. This case highlights the use of electrical bone stimulation in the management of a non-union cuboid avulsion fracture. Purpose (a): In this report, we assess electrical bone stimulation in the management of a non-union cuboid avulsion fracture in place of surgical intervention in a 30-year-old female. Methods (b): We reviewed the patient's medical record and imaging to provide a summary of the case presentation and X-ray findings. Review of the literature was also conducted to research the use of electrical bone stimulation in non-union fractures. Results (c): The patient was diagnosed with a closed, slightly displaced avulsion fracture of the right cuboid and was managed conservatively. Initial conservative management failed, however after two months of continued electrical bone stimulation and immobilization, bony union with osseous bridging was apparent on imaging. The patient was able to avoid surgery and began a rehabilitation program. She has since made a full recovery. Conclusions (d): Electrical bone stimulators can serve to enhance healing conservatively, and in cases that are recalcitrant to other modes of conservative therapy. Bone stimulation also provides a less invasive, less costly option leading to decreased morbidity. The use of bone stimulation in non-healing fractures may enhance and expedite the healing process. Conduction of larger studies and on various bones is necessary to assess the efficacy of this treatment and to fully utilize this management option in the future.