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Arthritis from trauma left cuboid

Posted by Mark K. on 11/07/02 at 23:22 (099618)

DR,
First of all thanks for doing this much needed service.

In 1965 I had an accident which a blunt force hit both my feet on the toes driving them back into the seat of a military vehicle. The result was fractured left cuboid left foot and severe sprain of (R) foot..

The military has had me on tylenol for these past many years saying it would evolve into degenerative arthritis. The pain is getting lkots worse and I can hardly walk without pain;. range of motion is fine but pain is severe.. Hard lump on left side of foot over cuboid, right side normal (bursitis?) Ortho doc told me it was a muscle... I was born at night but not last night..

They took xrays of the foot and after 35 years said there was no indication of fracture (DUH), but issued me handicapped parking sticker for car listing severely unable to walk due to arthritic,orthopedic or neurologic condition (sp)

They are saying I dont have arthritis cuz I have range of motion and no sign of fracture. I have motion but it hurts like hell and after a short walk it swells and I am down sometimes for 2 days. No prob with (R) foot, but some with right ankle from the sprain I think. I read an article where it said sometimes it doesnt show on xrays or if it was knocked out just a silly little millimeter and was a weight bearing bone it would rub.. no signs of deterioration I dont think but possibly the cartelage was torn and the slippery stuff aint got nothing to slide on that is smooth anymore..

Only thing they did was put me in a cast and shot the bone with cortezone twice.. then told me to take darvon and tylenol and after a while it would develop into degenerative arthritis.. I refused foot fusion but it was offered and the doctor said he thought I did right by refusing it because they werent too good at it back then...

Can I ask if I am even close to correct ? Does it not show up on exrays sometimes ? does it sound like a bursa over the cuboid ? I do have pain across my arch.. they have me on T4w60mg codiene for it...

In advance ,
Thank You
Mark Keeley Disabled Viet Nam Vet

Re: Arthritis from trauma left cuboid

Richard, C.Ped on 11/08/02 at 08:42 (099624)

Hi Mark,
First of all, thank you for your service to our country. I know you didn't ask about this, but I can give you an orthotic perspective for your situation. I have had many injuries for Workers Comp injuries as well as sports type injuries dealing with fractured cuboid bones. I'm not saying that my way is the only way, but I have had great success with all of them.

I have made a 'soft' orthosis using 1/2' 40 durometer EVA for the posting and 1/8' 30 durometer for the shell. As with all my orthotics, I grind them flat on the bottom. With the cuboid injury (or any other that require this) I have ground out the area were the cuboid sits. What this does is allow the cuboid to 'sit' in a 'pocket' while the weight is distributed away from the bone. It is a simple orthotic to make and as I said, I have never had a problem with it.

Just a thought. Take care!
Richard, C.Ped

Re: Arthritis from trauma left cuboid

Mark K. on 11/08/02 at 20:34 (099650)

Thanks for the info on that I will suggest it to them....

I am concerned that the osteoarthritic area isnt showing up on the xrays... I understand that that is only recognized by a narrowing of the space between the foot bones but dont know how it goes with the cuboid.

Additionally, with a bursa that they are telling me is a muscle, that fluid is not revealing the lack of cartilage there in order for the bone ends to deteriorate enough to be that visible....

What are your thoughts on that ?

Regards,
Mark

Re: Arthritis from trauma left cuboid

Richard, C.Ped on 11/08/02 at 08:42 (099624)

Hi Mark,
First of all, thank you for your service to our country. I know you didn't ask about this, but I can give you an orthotic perspective for your situation. I have had many injuries for Workers Comp injuries as well as sports type injuries dealing with fractured cuboid bones. I'm not saying that my way is the only way, but I have had great success with all of them.

I have made a 'soft' orthosis using 1/2' 40 durometer EVA for the posting and 1/8' 30 durometer for the shell. As with all my orthotics, I grind them flat on the bottom. With the cuboid injury (or any other that require this) I have ground out the area were the cuboid sits. What this does is allow the cuboid to 'sit' in a 'pocket' while the weight is distributed away from the bone. It is a simple orthotic to make and as I said, I have never had a problem with it.

Just a thought. Take care!
Richard, C.Ped

Re: Arthritis from trauma left cuboid

Mark K. on 11/08/02 at 20:34 (099650)

Thanks for the info on that I will suggest it to them....

I am concerned that the osteoarthritic area isnt showing up on the xrays... I understand that that is only recognized by a narrowing of the space between the foot bones but dont know how it goes with the cuboid.

Additionally, with a bursa that they are telling me is a muscle, that fluid is not revealing the lack of cartilage there in order for the bone ends to deteriorate enough to be that visible....

What are your thoughts on that ?

Regards,
Mark