Bipartition of the medial cuneiform is a well-described but rarely seen anatomic variant. The majority of literature focuses on anatomic description and incidents based on studies of archeological collections. Symptomatic cases can be overlooked or misdiagnosed initially given the vague complaint of pain either chronic in nature or following an acute injury that could result in a myriad of foot conditions. Treatment ranges from orthotics, immobilization, injection therapy, and surgery. Presented here is a series of 5 cases treated successfully with conservative and surgical measures.
BurnettSECaseDT. Bipartite medial cuneiform: new frequencies from skeletal collections and a meta-analysis of previous cases. Homo. 2001;62:109-125.
2.
BarclayM. A case of duplication of the internal cuneiform bone of the foot (cuneiforme bipartitum). J Anat. 1932;67:175-177.
3.
BarlowTE. Os cuneiforme 1 bipartitum. Am J Phys Anthropol. 1942;29:95-111.
4.
DwightT. Variations of the Bones of the Hands and the Feet. Philadelphia, PA: JB Lippincott; 1907.
5.
HoltbyJRD. Symmetrical division of the medial cuneiform bone of the foot. Trans R Acad Med Ireland. 1916;34:185-187.
6.
JashashviliTPonce de LeonMSLordkipanidzeDZollikoferCPE. First evidence of a bipartite medial cuneiform in the hominin fossil record: a case report from the Early Pleistocene site of Dmanisis. J Anat. 2010;216:705-716.
7.
JonesS. Right foot showing two internal cuneiform bones. Trans Pathol Soc. 1864;15:189-190.
8.
KjellströmA. A case study of os cuneiforme mediale bipartum from Sigtuna, Sweden. Int J Osteoarcheol. 2004;14:475-480.
9.
SmithT. A foot having four cuneiform bones. Trans Pathol Soc. 1865;17:222-223.
10.
AlemdarCUçarBYYıldırımAKapukayaA. Nonunion of the medial cuneiform: a rare case. Case Rep Med. 2013;2013:215756. doi:10.1155/2013/215756.
11.
AzurzaKSakellariouA. “Ostoesynthesis” of a symptomatic bipartite medial cuneiform. Foot Ankle Int. 2001;22:499-501.
12.
BismilQFosterPALVenkateswaranBShankerJ. Symptomatic bipartite medial cuneiform after injury: a case report. J Foot Ankle Surg. 2005;11:55-58.
13.
BryantMJBairdDS. A case of non-union of the medial cuneiform. Injury. 1993;24:207-208.
14.
ChiodoCPParentisMAMyersonMS. Symptomatic bipartite medial cuneiform in an adult athlete: a case report. Foot Ankle Int. 2002;23:348-351.
15.
DellacorteMPLinPJGrisafiPJ. Bilateral bipartite medial cuneiform. A case report. J Am Podiatr Med Assoc. 1992;82:475-478.
16.
EliasIDheerSZogaACRaikuSMMorrisonWB. Magnetic resonance imaging findings in bipartite medial cuneiform—a potential pitfall in diagnosis of midfoot injuries: a case series. J Med Case Rep. 2008;13:272.
17.
EvesTBAhmadMAOddyMJ. Sports injury to a bipartite medial cuneiform in a child. J Foot Ankle Surg. 2014;53;232-234.
O’NealMLGaneyTMOgdenJA. Fracture of a bipartite medial cuneiform synchondrosis. Foot Ankle Int. 1995;16:37-40.
20.
PanuAKoninGSaboeiroGSchneiderR. Symptomatic bipartite medial cuneiform treated with fluoroscopic and ultrasound-guided injections. HSS J. 2014;10:92-97. doi 10.1007/s11420-013-9365-5.
21.
ChangGHChangEYChungCBResnickDL. Bipartite medial cuneiform: case report and retrospective review of 1000 magnetic resonance (MR) imaging studies. Case Rep Med. 2014;2014:130979. doi:10.1155/2014/130979.
22.
GulerFBazABTuranAKoseOAkalinS. Isolated medial cuneiform fractures: report of two cases and review of the literature. Foot Ankle Spec. 2011;4:306-309.
23.
OlsonRCMendicinoSSRockettMS. Isolated medial cuneiform fracture: review of the literature and report of two cases. Foot Ankle Int. 2000;21:150-153.
24.
PattersonRHPetersenDCunninghamR. Isolated fracture of the medial cuneiform. J Orthop Trauma. 1993;7:94-95.
25.
TaylorSFHeidenreichD. Isolated medial cuneiform fracture: a special forces soldier with a rare injury. South Med J. 2008;101:848-849.
26.
SchadeVLRoukisTS. Percutaneous bone marrow aspirate and bone graft harvesting techniques in the lower extremity. Clin Podiatr Med Surg. 2008;25:733-742.
