A Jones fracture refers to a break between the base and shaft of the fifth metatarsal bone of the foot. The fifth metatarsal is the long bone on the outside of the foot that connects to the smallest toe.
This fracture takes its name from the orthopedic surgeon, Sir Robert Jones, who first reported and treated the injury in 1902.
A Jones fracture occurs in a part of the foot known as the metaphyseal-diaphyseal junction.
This area is between the base and shaft of the fifth metatarsal, a long bone that runs along the outside of the foot from the smallest toe to the ankle.
The area receives less blood than other regions of the foot, which can make healing difficult.
What are metatarsals?
The metatarsal bones are the long bones on the top of the foot that connect the ankle with the toes. There are five metatarsals in each foot. Each metatarsal bone has a base located next to the heel, a shaft, a neck, and a head.
The fifth metatarsal is the metatarsal on the outside of the foot that connects the ankle with the little toe.
It is slightly different from the other metatarsal bones. It bulges slightly at its base, while the other metatarsals do not.
The metatarsal bones help people balance while standing and walking. Because these bones get much more use than other bones, it is easy to injure them through overuse. Sudden acute injuries of the metatarsals are common after a sudden impact or severe twist of the foot.
A Jones fracture has many of the same symptoms as other types of fractures. A person with a Jones fracture may know they have injured their foot right away if the injury is sudden and causes immediate symptoms.
These symptoms include:
- pain and swelling on the outside of the foot at the base of the little toe
- problems walking
A Jones fracture is one of three basic types of fracture that can affect the fifth metatarsal.
The other two types of fractures in the fifth metatarsal are:
Avulsion fracture: This fracture often happens with ankle sprains. It occurs at the base of the fifth metatarsal.
It usually occurs when there is a traumatic pulling of a tendon or ligament from the end of the metatarsal.
The fracture is always transverse, with a horizontal fracture line, according to the American Association of Orthopaedic Surgeons (AAOS). It usually results in little to no displacement.
Spiral or oblique shaft fracture: Trauma or stress placed on the bone closer to the fifth toe can cause a spiral or oblique fracture. This fracture is very unstable and may result in displacement.
Anyone who suspects they have a fracture should see a foot and ankle specialist as soon as possible.
If an injury is acute, which means it happens suddenly rather than over an extended period, seek medical care promptly.
Also, seek urgent medical attention if any of the following symptoms occur:
- a worsening of swelling, pain, numbness, or tingling in the affected leg, ankle, or foot
- purple skin on the leg or foot
A medical professional can determine whether a person has a Jones fracture or another type of metatarsal fracture, and they can provide appropriate treatment.
A Jones fracture can be troublesome and is often slow to heal. It is essential to get a correct diagnosis to ensure proper management.
To make a formal diagnosis of a Jones fracture, the doctor will:
- ask how the injury happened or when the pain started
- examine the foot
- assess the location of the pain by pressing on different areas of the foot
- take X-rays and other imaging scans
Treatment will depend on several factors, including:
- the individual’s activity level
- the severity of the break
- the overall health of the person
People can begin caring for a Jones fracture even while waiting for a doctor’s care.
As soon as pain occurs, a person can perform the RICE method to reduce pain and swelling.
The RICE method involves:
- Resting the injury
- Icing areas of pain and swelling with an ice pack or ice wrapped in a cloth
- Compressing the affected area with an elastic wrapping
- Elevating the injured foot above the level of the heart
These methods might help prevent a Jones fracture from getting worse while waiting for treatment.
Where possible, the treatment will be nonsurgical.
Treatment typically involves wearing a non-weight-bearing cast to support the foot for about 6 to 8 weeks.
This is roughly the time it takes for a Jones fracture to heal.
However, a Jones fracture is often slow to heal or resistant to healing, and there is a risk of reinjury. Sometimes, a doctor may recommend surgery
According to an article published in the journal American Family Physician, a doctor may recommend surgery for some types of fracture or if the person is an elite athlete.
The incision required to repair a Jones fracture is minimal. This means that the surgeon can operate on a person on an outpatient basis, using general or local anesthesia.
Surgeons commonly repair these fractures by inserting a screw, rod, or plate.
During the procedure, the surgeon uses X-rays to ensure proper screw placement. The screw crosses the site of the fracture and squeezes the ends of it together.
Sometimes, a person may need a bone graft, particularly if they have experienced repeated fractures that have not healed with other treatment. In these cases, a surgeon may need to make a separate incision to perform the bone graft.
Since there is limited blood flow to the area, a Jones fracture has a higher chance of not healing than other metatarsal fractures, unless a person has surgical treatment.
If a person puts weight on the fracture, displacement can result. This means the ends of the bones do not line up correctly. In this case, too, surgery may be necessary.
Complications of surgery include:
- problems related to surgery and anesthesia, such as blood clots
- the need for repeated surgery
- refracturing after healing
- muscle atrophy
- continued pain and swelling
The healing time for a Jones fracture depends on the treatment method, the severity of the fracture, and the individual. With a cast, a Jones fracture usually takes 6 to 8 weeks to heal, but it can take up to 12 weeks.
However, between 15 and 20 percent of Jones fractures may not heal without surgery.
A person who has had surgery to repair a Jones fracture can expect a return to all activity, including sports, approximately 4 months after surgery.
However, the doctor may recommend a period of physical therapy to recondition the injured area.
More severe fractures that require bone grafting may require longer recovery times.
Tips and exercises for a good recovery
Some tips for a successful recovery include:
- keeping all weight off the foot for as long as the doctor recommends
- raising the foot while seated whenever possible
- managing any pain with ibuprofen after the first 24 hours
Following all of the doctor’s recommendations and guidelines will increase the chance of a successful recovery.