A Jones fracture is a fracture of the fifth metatarsal base. The pain will be located in the middle of the foot in the area of the fracture. A person who has sustained a Jones fracture will have pain and swelling in the area, and will typically have difficulty walking. In injury was first described in 1902 by Sir Robert Jones, a British orthopedist.
Jones fractures are diagnosed by using x-rays. The ordering physician will usually be able to see the fracture line through the fifth metatarsal. The fracture is located at the proximal end of the fifth metatarsal, through the diaphyisis. This is the long, tubular part of the bone.
Because of the location of a Jones fracute, they can often be difficult to heal. The area of bone that is fractured lies between the insertion point of two tendons. These tendons function to pull the bone in two different directions. When there is a fracture between theses two insertion points, that can lead to a lot of motion at the fracture site and therefore, prolonged healing time.
This area of bone also has a decreased blood supply when compared to the bone surrounding it. This is sometimes referred to as a watershed area in the medical community, meaning that the area of bone is not well vascularized, which can also lead to a longer time to heal.
In order to allow a Jones fracture to heal, the patient must be non weight-bearing for a minimum of four to eight weeks. However, due to the decreased vascularity and excessive motion caused by tendon insertion and muscles originating from the area, this is often not enough time for the fracture to heal. In some cases, it may take up to twenty weeks for the fracture to heal.
Surgery is often indicated for a Jones fracture. Reattaching the broken bone using pins, screws, or plates will frequently allow a stable fixation of the fracture. This stable fixation is key to the healing process. The prognosis for Jones fracture is greatly improved with the use of surgical correction.
Other fractures of the proximal fifth metatarsal include avulsion-type fractures as well as stress fractures. These types of fractures generally heal faster and more readily than the Jones fracture, partly because of where they occur in the bone. The areas of the bone affected by these other fractures are generally more protected by the tendons inserting in the area, and have a greater vascular supply. These types of cases typically will not require surgery, and will respond well to casting and immobilization.
