Description
Jones fractures are named after Sir Robert Jones, an orthopaedic surgeon who reported on his injury and those of the patients he treated. A jones fracture is a break in the bone of the 5th metatarsal (bone in alignment with the little toe). This injury may result from acute trauma such as excessive inward twisting of the foot as well as repetitive trauma (3). This injury is divided into 3 zones as depicted below.
Signs and symptoms (3)
Pain at the outer aspect of the foot.
Tenderness
Swelling
Pain with jumping/landing
Difficulty walking/limpingHow is a Jones fracture diagnosed?
A jones fracture diagnosis can be made with radiographic imaging. If a Jones fracture is suspected, your attending physiotherapist will refer you for an x-ray. Your physiotherapist may have this suspicion based on their clinical assessment (4).
Does this require surgery?
Treatment options are based on the injured zone. Zone one injuries can be managed conservatively and are initially immobilized in the form of cast or boot. Zone 2 and 3 fractures are more severe and may have better outcomes with surgical intervention (1)
What do both approaches (conservative and surgical intervention) look like? (2)
Surgery consists of the use of internal fixation in the form of a screw with or without bone grafting (Chlorus, et al., 2021). After the surgery your orthopaedic surgeon is likely to place you in a moon boot as well as 2 crutches so that minimal weight is placed through the foot. For the more conservative approach, one is usually casted for 6-8 weeks depending on the severity of the fracture. It is likely that return-to-sport will be quicker when surgery is carried out. Both approaches will require a visit to a physiotherapist for optimal results.
What is the role of Physiotherapy? (1)
Swelling and pain management
Gait re-education and the optimal management of the amount of load being placed through the foot.
Active range of motion exercises of the ankle with caution on twisting the foot inward and outward.
Footwear advice and the referral for orthotics if required.
Foot intrinsic muscles strengthening
Stretching
Calf muscle strengthening
Balance training
Agility training
Jumping and landing training.If you are battling with pain at the outer aspect of your foot, do not hesitate to book an appointment with one of our experienced physiotherapists for a thorough evaluation.
References
1.Albloushi, M., Alshanqiti, A., Qasem, M., Abitbol, A., & Gregory, T. (2021). Jones type fifth metatarsal fracture fixation in athletes: A review and current concept. World Journal of Orthopedics, 12(9), 640-650.
2.Aynardi, M., Walley, K., & Wisbeck, J. (2019). Intramedullary Screw Fixation of Jones Fracture: The Crucial Starting Point and Minimizing Complications. THE ORTHOPAEDIC JOURNAL AT HARVARD MEDICAL SCHOOL, 20, 42-45.
3.Chlorus, G., Kakos, C., Tastsidis, I., Giannoudis, V., Panteli, M., & Giannoudis, P. (2021). Fifth metatarsal fractures: an update on management, complications, and outcomes. Effort open reviews, 7, 13-25.
4.Dean, B., Kothari, A., Uppal, H., & Kankate, R. (2012). The Jones Fracture classification, management, outcome and complications. Foot and Ankle Specialist, 5(4), 256-259.