Nutcracker Fracture

A fracture that occurs with the forefoot everted on hindfoot pinching cuboid between anterior calcaneus and bases of 4th and 5th metatarsals
DiffDx Navicular fracture, navicular stress fracture, Lisfranc fracture, talar head fracture
Management Avulsions: one week of non-weight bearing, elevation followed by progressive weight bearing and functional rehab. Displaced and/or compression fracture: open reduction and internal fixation and possible bone grafting to prevent late painful arthritis
Complications Stiffness, non-union, osteonecrosis, deformity, postraumatic arthritis; untreated displaced/compression fractures can lead to relative shortening of the lateral column, planus and abduction deformities of the midfoot and chronic pain