A Jones fracture is a crack in the bone at the 5th metatarsal or little toe. The 5th metatarsal fracture occurs at the midfoot at the top of the bone near the ankle. So, why is a jones fracture essential to diagnose, and what should you do?
What are the causes of Jones fracture?
Jones fracture or 5th metatarsal fracture can be due to an acute injury such as an ankle twist or chronic overload. However, this fracture can occur without an acute injury. Repetitive injury can lead to the weakening or cracking of the bone. Therefore, it is often referred to as a stress fracture.
Diagnosis of a fracture of the 5th metatarsal
Generally, Jones’s fracture presents as acute pain in the outer part of the mid-foot. However, people with this injury have pain outside the ankle or foot. They also report swelling and difficulty with weight-bearing.
Typically, there is tenderness at the 5th Metatarsal or little toe base.
Overall, investigations are essential to confirm the diagnosis and exclude other causes of pain outside the mid-foot. An X-ray can localise the site of the fracture.
Importantly, your doctor needs to differentiate a Jones fracture from other fractures of the 5th Metatarsal. A Jones fracture occurs in the zone between the shaft and the tip of the bone. This fracture is different from other fractures in the little toe. For example, ankle sprains cause avulsion fracture of the 5th Metatarsal. Therefore, we treat these fractures with a walking boot. Also, Dancer’s foot corresponds to a fracture of the middle of the 5th Metatarsal. Similarly, treatment is a boot unless the fracture ends are significantly displaced.
What should you do about a Jones fracture?
When you’ve confirmed a diagnosis of a Jones fracture, you need to decide on management. Generally, these 5th metatarsal fractures are slow to heal because of reduced blood supply. Therefore, your doctor should discuss initial treatment with the person with the fracture.
Non-operative treatment
Generally, non-operative treatment consists of weight-bearing rest with a CAM walker boot. Patients use crutches for the first few weeks. CAM walker boot is used continuously for the first six weeks. After six weeks, People can remove the CAM walker boot and slowly move into weight-bearing activities as the fracture heals. Transitioning from walking boot to shoe takes about two weeks. Then, movement can progress from walking to running gradually.
Other treatments that enhance healing include Vitamin D and calcium optimisation, focussed shockwave and LIPUS therapy. Sometimes, other tests are needed to assess bone health including blood tests and bone density testing.
In total, patients often require three months for healing.
Surgery
Generally, we consider immediate surgery for athletes with a Jones fracture to avoid lengthy healing periods. However, surgery also has risks and has to be weighed against the risk of delayed healing.
Typically, the most common bone fixation method is using a bone screw. This is because we think a screw helps the bone to heal in 8 weeks.
Final word from Sportdoctorlondon
Overall, we need to be careful with fractures of the 5th toe. However, if the fracture occurs at the base of the 5th metatarsal, you should see an expert in Sports Medicine who can guide you regarding proper treatment.
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