Medial cuneiform fracture

Isolated medial cuneiform fractures are rare, and fractures of the medial cuneiform are more commonly seen in combination with other fractures of the foot.


Most commonly, fractures of the cuneiform bones occur in combination with other fracture-dislocations of the midfoot . When in combination with other fractures, the medial cuneiform is more commonly fractured than the intermediate or lateral cuneiforms. In one retrospective study of a single University hospital, over a ten-year-period, 30 cases of cuneiform fractures were identified, of which two-thirds were of the medial cuneiform .

True isolated fractures of the cuneiform bones are rare, accounting for only 1.7% of all midfoot fractures . Only one case of bilateral synchronous isolated medial cuneiform fractures has been reported .

Clinical presentation

With regards to isolated fractures of the medial cuneiform, and based on the small number of cases in the literature, patients most commonly present after direct trauma . In some cases acute bruising and swelling were present in the tarsal region however this has not been an invariable finding .

Radiographic features

Most patients will have plain radiography before cross-sectional imaging is performed and fractures of the medial cuneiform can be difficult to spot.

Differential diagnosis