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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. In addition, narrow, flexible shoes have been demonstrated to be a risk factor.
Jones fractures produce pain, swelling, bruising, and difficulty walking. Some people may experience pain before the fracture occurs. In stress fractures or overuse fractures, the pain may only occur during exercise.
A Jones fracture can occur when the foot twists inward (adduction) or down (plantarflexion). Stress fractures can occur in this area when there is a recent increase in high-impact activity (for example, marathon training). A combination of an acute fracture through an area of chronic stress is also possible.
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 and the patient has persistent symptoms. A CT scan can be useful to gauge fracture healing.
Your foot and ankle orthopaedic surgeon may recommend treating the Jones fracture without surgery. This involves a period of immobilization in a cast, boot, or rigid shoe. You may be asked to be non-weightbearing for the first 6 weeks. Be prepared for a long healing period as it can take 12 weeks to heal a fracture in this area due to diminished blood supply.
Despite doing everything right, 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 evidence of healing, surgical treatment may 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 use internal fixation to stabilize the fracture while it heals.
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.
Return to athletic activity and standard shoes can take 8-12 weeks with or without surgery. Your foot and ankle orthopaedic surgeon may allow you to start non-impact activities sooner if there is evidence of healing on X-rays. It can take 4-6 months to resume sports. After the bone has healed, some patients will need physical therapy to regain motion and strength.
All surgeries come with possible complications, including the risks associated with anesthesia, infection, damage to nerves and blood vessels, and bleeding or blood clots. Numbness on the outside of the foot in the area of the incision can occur.
Sometimes the bone will take longer to heal. If this happens, either surgery, repeat surgery, or a bone stimulator is recommended to help healing. Jones fractures also have a high rate of refracture, which occurs more frequently with non-surgical treatment.
Athletes typically return to training at around 8 weeks. Athletic trainers and physical therapists help with this process. Some may wear shoe inserts or braces when returning to sports, particularly athletes who play on hard surfaces such as artificial turf.
Yes, you can wait. However, postponing surgery may change the way your surgery is performed.
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; Paul Ryan, MD
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