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Jones Fractures
What is Jones Fracture?
Jones Fracture Definition
A
Jones fracture is a specific type of foot fracture involving the outside
portion of the foot and specifically the fifth metatarsal bone.
The
location and pattern of this fracture within the fifth metatarsal bone is
itself characteristic. The fracture pattern is horizontal/transverse. And, the fracture
location within the fifth metatarsal bone is near the midfoot at the
base of the fifth metatarsal bone where the narrow portion of the bone(
Diaphysis) begins to widen (Metaphysis) .
This area of the fifth metatarsal bone receives minimal
blood supply. This" hypovascularity" makes this specific
type of fracture difficult to heal and more prone to requiring
surgical treatment.
Jones Fracture Symptoms and Anatomy
Symptoms include pain, swelling and sometimes bruising along
the outside portion of the midfoot. Sometimes patients will report feeling a
pop or snap in that area. Foot structure and foot alignment may also play a
role. High arch / "cavus foot " pattern increases the risk of a Jones fracture.
These fractures can occur slowly due to overuse- such as
ramp up of endurance training. These fractures can also occur suddenly- such as
inwardly rolling the foot.
Jones Fracture Treatment
Nonsurgical treatment: up to 20% of Jones fractures may
develop nonunion or delayed union with appropriate non-surgical treatment.
For a sudden injury/fresh Jones fracture without displacement (no malalignment or offset between bone ends at fracture site) Treatment may include short leg cast or boot walker non weight- bearing for six weeks followed by weight-bearing for six weeks. Additional treatments that could be added to increase the rate of healing include bone stimulator devices.
Jones Fracture Surgery
For a non-sudden variety stress fracture or for a sudden
fracture that has no evidence of healing after six weeks treatment or a
fracture showing x-ray displacement : - minimal incision surgical intervention
with an intramedullary screw is the treatment of choice. This allows for the early ability to achieve weight-bearing status and has a low chance of
non-union and allows early return to sports,
For older fractures that failed to heal with screw (established nonunion) or that show a wide gap on x-ray (hypotrophic nonunion); a more invasive open incision with bone graft and compression plate screw/fixation may be more appropriate.