Return-to-Tennis Considerations and an Elusive Diagnosis for a Cuboid Avulsion Fracture: A Disablement Model Case Study

Abstract

This disablement-model case study is focused on a 23-year-old NCAA Division I men’s tennis player that sustained an injury in a competitive singles tennis match. Upon initial examination, the athletic trainer diagnosed the individual with an anterior talofibular ligament sprain and treated conservatively. The patient experienced significant disruptions to his activities of daily living due to his difficulties with ambulation during the early stages of his recovery. Interestingly, the patient was eventually diagnosed with a cuboid avulsion fracture. Midfoot fractures are uncommonly experienced in the general population, and are particularly uncommon in tennis athletes, making them difficult to recognize. Clinical prediction rules may be used to guide the decision to order imaging, however, they must be used in conjunction with pertinent clinical findings when a midfoot fracture is suspected. With rest and targeted rehabilitation, the patient successfully returned to his pre-injury levels of strength, range of motion, and perceived level of physical function in his lower extremity.