Injury patterns, in-hospital outcomes, and resource utilization of acute cuboid and navicular fractures.

Abstract

Background: Acute cuboid and navicular fractures can be serious injuries. However, multicenter data on their associated injuries and in-hospital course are limited.

Purpose: To characterize the demographics, injury patterns, in-hospital outcomes, and resource utilization of trauma center patients with acute cuboid and/or navicular fractures.

Study design: Retrospective cross-sectional database study.

Methods: The American College of Surgeons National Trauma Data Bank (2017-2019) was queried for acute cuboid and/or navicular fractures. Multivariable regression identified factors associated with discharge to post-acute care, intensive care unit (ICU) admission, and hospital length of stay in adults.

Results: Overall, 3,424 patients with 4,084 fractures were identified (2,327 with cuboid and 1,637 with navicular fractures, including 540 with both). Road-traffic mechanisms accounted for 64.5%, and 25.1% had polytrauma. Metatarsal, calcaneal, and talar fractures were the most common concomitant injuries. Combined fractures were more often ipsilateral than contralateral (457 vs 18 patients). Despite infrequent complications, 50.2% were discharged home without post-acute services (home health, inpatient rehabilitation, or skilled nursing care). In-hospital mortality was 1.1%. After adjustment, polytrauma (OR 3.75, 95% CI 3.04-4.61), bilateral involvement, and ankle, tibia, fibula, or metatarsal fractures were associated with discharge to post-acute care, whereas fracture pattern was not.

Conclusions: Cuboid and navicular fractures are predominantly high-energy injuries that rarely occur in isolation. Post-acute care needs, ICU admission, and length of stay were associated with overall injury burden rather than the specific bone fractured.