The sports docs’ weekly blitz: The Jones fracture

Cyclone Fanatics,

This week we are going to learn about Jones fractures, a term used to describe a break of the fifth metatarsal, which is the long bone on the outside of the foot that connects to the little toe.

Jones fractures have been in the sports news lately since Kevin Durant tweeted on October 16th he had "successful surgery" regarding treatment of his Jones fracture. 

It is a common injury in basketball players, both professional and college-including ISU players, as well as other athletes, including football and soccer players. Running and jumping places extreme stress on the foot, especially if the athlete has a high arch and has increased force on the outside part of the foot. 

Jones fractures occur toward the base of the fifth metatarsal where it joins with the shaft, in an area of the bone that has poor blood supply. This lack of blood supply accounts for its difficulty to heal. Jones fractures can either be as a result of an overuse injury, a stress fracture (tiny hairline crack that occurs over time, leading to pain on the outside of the foot), or an acute injury, such as when an athlete rolls the foot inwards feeling intense pain and often times hearing a "crack". There is pain, swelling and tenderness at the fracture site and it is difficult to bear weight. Diagnosis is confirmed by x-ray. 

Treatment options include nonsurgical casting with prolonged non weight bearing status. This can lead to a great deal of deconditioning and there is a high refracture rate when one finally returns to activity. For these reasons, as well as allowing an earlier return to sporting activity, most athletes choose operative treatment. 

Surgical treatment involves the placement of a screw down the middle of the fifth metatarsal to stabilize the fracture. It should be mentioned that surgical intervention is not, by itself, a guarantee of cure and has its own potential complications. The body’s natural processes still needs to heal the fracture, and this can take a period of 6-8 weeks, with full return to sport sometimes taking up to several months. 

During the healing process the athlete can stay in shape by riding an exercise bike, as well as running in the SwimEx Hydroworx Pool. As the fracture heals more, the athlete is allowed to do more. Once complete healing occurs, the athlete typically does well, allowing full return to a pre-injury competitive level.

Jones fracture (white arrow) with wire before screw placement. 

Jones fracture with screw fixation. 

Healed Jones fracture allowing return to sports activity.