What Is a Jones Fracture?

A Jones fracture is the name often used for a fracture at the base of the fifth metatarsal, the bone on the outer side of your foot. Jones fractures are one of the most common foot injuries. This broken bone may heal slowly because of poor blood supply to the area and the amount of force placed on this part of the foot. Those with high-arched feet especially are at risk for a Jones fracture because they put more pressure on the outside of their feet.

Symptoms

Jones fractures produce pain, swelling, bruising, and difficulty walking. Some people may experience pain before the fracture occurs.

Causes

A Jones fracture can occur when the foot twists. Stress fractures can occur in this area when there is a sudden increase in high-impact activity (for example, marathon training).

Diagnosis

A Jones fracture typically is visible on X-rays of the injured foot. An MRI may be helpful if the fracture is not seen on X-ray. A CT scan can be useful to gauge fracture healing. 

Treatments

Your foot and ankle orthopaedic surgeon may recommend treating the Jones fracture without surgery. This involves a period of immobilization in a non-weightbearing cast or boot. Studies have shown that some of these injuries fail to heal. For this reason, repeat X-rays are necessary to ensure appropriate healing. If X-rays do not show healing in six weeks, then surgical treatment should be considered.   

Surgery is most common for Jones fractures in athletes or when non-surgical treatment isn’t successful. During surgery, your foot and ankle orthopaedic surgeon will insert a screw to stabilize the fracture while it heals.

Preoperative X-ray of a Jones Fracture

Above: An X-ray image of a Jones fracture

Below: An X-ray image of a repaired Jones fracture after surgery. The surgeon has inserted a screw to stabilize the fracture while it heals.

Postoperative X-ray of a repaired Jones Fracture

Recovery

Recovery is about eight weeks with or without surgery. After the bone has healed, some patients will need physical therapy to regain motion and strength.

Risks and Complications

All surgeries come with possible complications, including the risks associated with anesthesia, infection, damage to nerves and blood vessels, and bleeding or blood clots.

Sometimes the bone will take longer than eight weeks to heal. If this happens, either surgery or a bone stimulator is recommended to help healing. Rarely, the fracture may not heal and the screw can break. If this happens, a second surgery may be performed. Jones fractures also have a high rate of refracture, which occurs more frequently with non-surgical treatment. 

When can I return to playing sports after a Jones fracture?

Athletes typically return to playing sports at around 8 weeks. Athletic trainers and physical therapists help with this process. Some may wear a clamshell orthosis or turf toe plate when returning to sports, particularly athletes who play on hard surfaces such as artificial turf.

Can I wait to have surgery until I see if the fracture doesn't heal?

Yes, you can wait. However, postponing surgery may make it more difficult.

Does the hardware need to come out?

No, the hardware does not need to come out for you to return to activities. However, if the screw head or hardware is prominent and irritated by shoes, it may need to be removed.

 

Original article by Joan Williams, MD
Contributors/Reviewers: Jeffrey Feinblatt, MD; Eric Tan, MD

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