Understanding the Jones Fracture of the Foot

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Jones fractures are located at the base of the 5th metatarsal bone. Dr. Neal Blitz / www.DrNealBlitz.com

What is A Jones Fracture?

A Jones fracture is a specific type of fracture involving the fifth metatarsal bone of the foot.  It is distinguished from other types of fractures involving the foot as it is located within an area of this bone that is difficult to heal.  The Jones fracture is generally a transverse fracture (meaning, oriented perpendicular to the long axis of the bone) and occurs in at a transition zone within the bone, where it goes from dense to spongy called the diaphyseal-metaphyseal junction of the 5th metatarsal.

 

What Are The Causes Of Jones Fractures?

Jones fractures may be the result of a specific traumatic event or a chronic overuse situation.  When they occur traumatically, it's usually the result of an inversion-type sprain, which is one where the foot is turned inward towards the other foot.  This is the same type of injury that can cause an ankle fracture.  When Jones fractures occur from a chronic problem the tend to be the result of repetitive overuse injuries that may slowly crack the bone or weaken it to a state where a traumatic acute break can occur.  

Who Gets Jones Fractures?

Jones fractures are common in athletes and have been known to occur in professional athletes.  Two recent professional athletes with these fractures are Kevin Durant-Jones Fracture (basketball) and Ahmed Bradshaw (football).  High arched feet tend to be more susceptible to Jones fractures because more pressure is placed on the outside of the foot on that specific area.

   

How Are Jones Fractures Treated?

Jones fractures generally are difficult because the fracture occurs in the area within the bone of lessened vascularity (blood supply), medically termed a watershed area.  Treatment of Jones fractures may be with casting and/or surgery.  The treatment plan often depends on the patient's age, activity level, overall medical health, and type of Jones fracture.

 Either way, bone healing takes 6-8 weeks.  

Non-operative Jones Fracture Treatment:  Those patients that are treated without surgery are generally recommended to be placed into a solid cast that starts below the knee and extends to the toes for a period of 6-8 weeks.  Doctors usually restrict the patient from walking on the leg and advice crutches, until bone healing is visualized on the x-ray.  Jones fractures are notorious for delayed healing and the process of casting and crutches can extend three or more months.

Jones Fracture Surgery:  Surgery for the Jones fracture is generally recommended in active people.  Athletes are almost always advised to proceed with surgery.  Younger patients are more suited for surgery but older patients may also be considered excellent candidates for surgery depending on their activity level.  

The most common method for surgery involved placing a single surgical bone screw to hold the bone fragments together.  This screw starts at the tip of the bone is inserted into the inner canal of the metatarsal bone.

 This screw orientation is unique in that no other foot fracture is treated with a screw oriented as such.  

Jones Fracture Recovery

Jones fractures, like any broken bone, take about 6-8 weeks for the fracture to mend - with or without surgery.  The challenge with Jones fractures is that the fracture occurs within a segment of bone that is considered less vascular, which ultimately means prolonged healing times.


Surgery, by placing the screw, is thought to help the bone heal in the normal amount of time of approximately six weeks.  Additionally, some surgeons allow for protected walking in after surgery for Jones fractures.  When treated without surgery (casts and crutches), the bone healing tends to extend beyond the six weeks, and may take 3 months or more.  Some doctors have prematurely recommended bone healing devices (called bone stimulators) for these fractures as a preemptive strike to try and thwart delayed healing.  

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