Dropped cuneiforms/navicular/cuboid are most commonly associated with which mechanism?

• A. Repetitive inversion injuries
• B. Landing injuries (stepped off a curb) or dropping heavy objects on the foot
• C. Forefoot abduction
• D. Achilles tendon rupture

Answer: (B)

Midfoot crush injuries happen when a heavy load is driven up through a plantarflexed forefoot, crushing and shifting the tarsometatarsal joints. The scenario of landing hard or dropping a heavy object on the foot delivers that axial load through the midfoot, which can cause the navicular, cuneiforms, and cuboid to drop out of alignment.

This mechanism fits best because it directly involves an axial load on the forefoot that disrupts the midfoot joints. In contrast, repetitive inversion injuries primarily injure lateral ankle ligaments, forefoot abduction points more toward Lisfranc-type ligament injuries, and an Achilles tendon rupture comes from a sudden forceful plantarflexion, not midfoot crushing.