What is a Jones (5th Metatarsal) Fracture? A Jones (5th Metatarsal) Fracture is a fracture of the base of the fifth metatarsal (long bone of the forefoot). Several types of fractures can occur in this area, and some require more treatment than others. A Jones Fracture can either be a stress fracture (a small hairline break that occurs due to repetitive stress) or an acute (sudden) fracture. A true Jones Fracture occurs in a certain region in the base of the fifth metatarsal. Jones Fractures are caused by overuse, repetitive stress, or trauma. Other fractures that can occur at this location include stress fractures, caused by repetitive stress, or avulsion fractures, where the muscle/tendon that attaches on that bone pulls off a piece of bone. Although Jones Fractures are less common than avulsion fractures, they are more difficult to treat due to a less than optimal blood supply in that area of the foot. Causes A twisting and inversion (turning the foot inward) motion. Signs & Symptoms Pain located at the base of the fifth metatarsal (lateral or outside aspect of foot). It is mostly painful to the touch. May be painful with weight-bearing ankle motion, such as during quick changes in directions; some athletes do not experience pain with weight bearing. Swelling and bruising are rarely present, but if they are, can be seen on the outside (lateral) portion of the foot. Treatment Non-operative Conservative treatment of a Jones Fracture is done in a short leg cast and towards the end of treatment, graduated to a walking boot. Weight bearing is progressively implemented with decrease in pain. Healing normally happens within 6-8 weeks, but could be longer depending on the severity of the fracture and how long the fracture has been present. If the fracture does not heal with conservative treatment, surgical intervention is necessary to stabilize the fracture. Operative Surgical management of a Jones Fracture is increasingly common due to the high non-union (poor healing) rate and the long recovery from non-operative care. Operative fixation of the fracture is done with a single screw placed inside the metatarsal bone. The screw can be removed if it causes pain in the future.
