What is it?
A Jones Fracture is a stress fracture of the 5th Metatarsal at the metaphyseal-diaphyseal junction. They are often the result of repetitive stress built up over time. These fractures can be slow to heal. There is a high incidence of non-union due to poor blood supply in this area. This is different from an avulsion fracture (Dancer’s Fracture) where the insertion of the Peroneus Brevis pulls the bone or a fracture of the distal metatarsal.
Mechanism of Injury:
This is an overuse, repetitive stress type of injury. Injury occurs with a repetitive load applied under the metatarsal head over a relatively short time such as in running.
* High arch
* Increased loading of the lateral foot possibly due to alignment of the lower extremity.
* Pain and swelling in the lateral foot.
* Difficulty walking.
Treatment is Variable:
Bony callus formation is visible on x-ray at 6-8 weeks post-injury. However, 1/3 of all Jones fractures end in non-union. Treatment options are as follows:
* Weight Bearing in a Cast/Boot: 6-8 weeks in a cast or boot but able to put weight on it.
* Non-weight Bearing: 6-8 weeks in a cast or boot without putting weight through the foot. 14-15 weeks ‘til return to activities.
* Operative: Shorter times to union and quicker return to sport. This is typical of the younger and athletic population. 4-6 weeks non-weight bearing with a return to sport around 8 weeks. This is also the choice if non-operative treatment fails or the fracture is displaced.
Andrea Bellitti, DPT
ProSport Physical Therapy, 2777 Bristol Street, Suite B, Costa Mesa, CA 92626. (949) 250-1112.