Stress Fracture of Isolated Middle Cuneiform Bone in a Trainee Physician: A Case Report and Review.

Abstract

Stress fractures are chronic fatigue failure of bone from repetitive subthreshold loads. Insufficiency fractures occur in bones that are already osteopenic and fail to withstand normal loads over time. Stress fractures of cuneiform bones are extremely rare and usually reported to happen in athletes or recruits. We describe a case of middle cuneiform insufficiency fracture that occurred in a young trainee physician with severe hypovitaminosis D, who joined his training a few weeks before it happened. Magnetic resonance imaging remains the modality of choice of diagnosis of foot stress injuries because it detects even stress reactions with reasonable sensitivity. Cuneiform stress fractures, like other low-risk stress fractures, heal with immobilization only and do not require surgical intervention.