Osteomyelitis of the cuboid treated with one-stage debridement and bone grafting: a case report and literature review.

Abstract

Background: Osteomyelitis (OM) is a challenging bone infection that commonly associated from trauma or surgical procedures. Although it typically affects long bones, osteomyelitis of the cuboid bone is rare due to its distinct anatomical features and abundant vascular supply. Early recognition and prompt treatment are essential for effective management.

Case presentation: We report a 52-year-old female presenting with persistent left foot pain and restricted mobility following a nail puncture injury three years prior. Initially managed with analgesics alone, her symptoms significantly worsened one month before presentation. MRI revealed abnormal signals in the cuboid bone, suggesting osteomyelitis. Bacterial culture, antibiotic susceptibility testing, and histopathological examination confirmed the diagnosis of chronic osteomyelitis caused by methicillin-sensitive Staphylococcus aureus (MSSA). The patient underwent surgical debridement and iliac bone grafting with local vancomycin. After six weeks of antibiotics, she exhibited excellent recovery at six months, with normalized gait, full joint motion, and no recurrence. One year postoperatively, the internal fixation was successfully removed after radiographic confirmation of complete fracture healing.

Discussion and conclusion: This report presents the diagnostic and therapeutic experience of an adult case of cuboid bone osteomyelitis. Early diagnosis and treatment of this condition are essential for enhancing clinical awareness, thus preventing misdiagnosis and delays in treatment. Surgical debridement, in conjunction with autologous bone grafting, can yield favorable outcomes.