Athletes who experience this injury present with pain in the base of their fifth metatarsal. They typically have difficulty bearing weight and ambulating.
Your provider will take a detailed history and perform an exam to assess your symptoms. They will also order an imaging test to determine the severity of your fracture.
Causes
The Jones fracture is a break in the base of the fifth metatarsal bone, on the outside of your foot. The injury often occurs in people who participate in sports that involve placing a lot of force on the foot while pivoting and changing direction. It also can be caused by wearing shoes that put too much pressure on the outside of the foot, such as high-arched feet.
This type of injury disrupts blood flow to the area, causing the bones to heal more slowly. A bone that isn’t getting enough blood can become inflamed, swell and lead to pain. UI Health Care doctors are experts at diagnosing Jones fractures and recommending the best treatment for each patient.
Most Jones fractures are non-displaced zone 2 injuries that can be treated conservatively with 6 to 8 weeks of non-weight bearing in a short leg cast. Patients can advance to weight-bearing as X-rays and the surgeon’s exam show evidence of healing.
If the Jones fracture is displaced, has not healed after several weeks of non-weight bearing or is in an active athlete who wants to return to their sport sooner, a foot and ankle surgeon may recommend surgery. There are several surgical techniques to consider, including intramedullary screw fixation and tension band constructs. Studies have demonstrated that utilizing longer cannulated screws leads to better outcomes with these injuries.
Symptoms
A Jones fracture is a break or crack in the fifth metatarsal bone, which extends from the base of your pinkie toe to the outer side of your foot. It’s a type of avulsion fracture, which occurs when part of the bone is separated from the rest because it’s attached to a tendon or ligament. This injury is common in athletes who twist their feet while they run or jump, and it can lead to severe pain if not treated properly.
You might notice swelling in the outside of your foot and ankle, and you may have difficulty putting weight on your foot. You might also have pain when you try to move your foot in certain ways, such as by pointing it down (plantarflexion) or lifting it upward (dorsiflexion).
Your doctor diagnoses Jones fractures with a physical exam and imaging tests. X-rays show the damage to your bones. Magnetic resonance imaging, or MRI, provides a more complete picture of the injuries to your bones and surrounding tissue.
Most nondisplaced Jones fractures can be treated without surgery. Your doctor might recommend a short leg cast or walking boot, and you’ll need to keep weight off the affected foot for about six to eight weeks. As your healing progresses, you can slowly increase the amount of time and intensity of your physical activities. However, this should be done carefully so that you don’t overdo it and worsen your injury.
Diagnosis
A Jones fracture is a break or crack in the fifth metatarsal, a bone on the outside of your foot. It usually happens when you twist your foot as you walk or run. It can also happen if you have high arches and wear narrow shoes. Most people who get Jones fractures heal without surgery.
Your healthcare provider will diagnose a Jones fracture with a physical exam and imaging tests. X-rays will confirm your injury and show how damaged your bones are. Your healthcare provider may also use magnetic resonance imaging (MRI) to get a better picture of your bone and the tissue around it.
The first step in treating a Jones fracture is to stop all activities that cause pain, swelling, and bruising in the outside of your foot. You may need to use crutches to help you get around while the broken bone heals. Your healthcare provider may recommend ice packs to reduce the swelling and inflammation from the injury. Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen can also be helpful.
Most people who have Jones fractures can return to their normal activities as the bone heals. For the best results, follow a diet and exercise plan that helps you maintain good bone health, and talk to your healthcare provider about getting regular bone density screenings if you’re over 50.
Treatment
In the early stages of healing, it’s important to limit your weight-bearing activity and use crutches to prevent pressure on your foot. You should also ice your foot several times a day, alternating 20 minutes on and 20 minutes off to decrease pain, swelling, and inflammation.
The doctor may recommend surgery if the fracture in your pinky toe side fifth metatarsal bone isn’t improving with non-surgical treatment. During surgery, our board-certified foot and ankle surgeon will set your fifth metatarsal bone by using a metal screw in the outside of your foot or heel. The screw stays in your foot when you heal to help hold your bones in place. Our surgeon may also insert a pin to keep the bone in place, but it doesn’t get removed.
We also recommend that athletes and patients who choose surgical treatment have a bone graft to help the area heal more quickly. A bone stimulator can also be used, delivering a weak electric current over the broken bone to speed up the growth of new bone.
Doctors will monitor your recovery with follow-up X-rays and CT scans to make sure your Jones fracture is healing properly. When your X-rays and CT scans show no signs of nonunion, our physical therapists will help you return to activities that require the use of your foot. They will help you regain strength, balance, flexibility, and coordination.