Jones Fracture and Metatarsal Fracture – Symptoms, Causes, Treatments, Surgery and Recovery

A Jones fracture, also known as a fifth metatarsal fracture, is a foot injury involving the fifth metatarsal, the long bone extending along the outside of the foot which connects to the small toe. This fracture is very common in athletes and can be caused by overuse or stress to this area of the mid foot. The Jones fracture can be mistaken for a simple ankle sprain, but in fact, it is much more serious. It is important to understand the implications of this injury, so read on to learn the following about a Jones fracture:

The Basics

The Jones fracture is a fracture of the fifth metatarsal and occurs at the base of this bone (portion closest to the ankle). Sir Robert Jones who suffered from this injury while dancing first described it in 1902.

While there are other types of injuries that occur on the fifth metatarsal, such as the avulsion fracture (also known as a Pseudo-Jones or Dancer’s fracture), these tend to be less severe in nature than the Jones fracture. The break associated with the Jones fracture occurs where the base of the bone connects to the shaft. It is prone to stress and receives less blood flow than other areas of the mid foot, both of which can cause difficulties in the healing process.

Causes

Defenders tackling running back carrying football

Jones fractures are caused by overuse and repetitive stress or trauma. Overuse and stress on the fifth metatarsal results in a hairline fracture that develops over time. This can be caused merely by walking, jumping, or running, and is often more noticeable in a patient with a high arch. Sudden trauma (an acute injury) to the foot, such as a turned ankle or other inward twisting of the foot, can also cause a Jones fracture. Jones fractures frequently affect professional athletes and caused lost playing time for Kevin Durant and Pau Gasol of the NBA and Dez Bryant of the NFL

Common Symptoms

doctor examining an injured foot

Symptoms of the Jones fracture include the following:

• Pain on the outside of the mid foot
• Tenderness to pressure or when walking on the outside of the mid foot
• Bruising
• Difficulty bearing weight or walking on the foot
• Chronic ache on the outside of the mid foot

Jones fractures are sometimes mistaken as an ankle sprain, but can be much more severe. If rest, ice, and elevation do not alleviate the pain in your foot after a few days and you suspect that you are suffering from a Jones fracture, you should seek medical attention right away. As mentioned, the area of the Jones fracture has a small blood supply, and the fracture further disrupts that supply, preventing proper healing to take place. Seeing a doctor early on will determine if you have a Jones fracture, the severity of the break, and will put you on the road to recovery much quicker.

The fracture can worsen if not treated appropriately, especially if the fracture is due to stress or overuse. If your doctor suspects a fracture to the 5th metatarsal, he/she will examine the foot, trying to determine the exact source and location of the pain, and will likely order an x-ray.

Treatment

Non-surgical Treatment

Rest, Ice, Compression, and Elevation — With many foot injuries, it is very important to initiate rest, ice, compression and elevation (R.I.C.E.) immediately. While this initial treatment can be time consuming, staying off the injured foot, icing it multiple times a day, wrapping the foot, and elevating the foot help to reduce swelling and increase blood flow to the area. This initial treatment will accelerate the body’s natural healing process.

Immobilization – a Jones fracture can heal if it is protected from weight bearing activities for a long period of time. A protective boot, cast, or stiff soled shoe may be suggested to support the foot and divert pressure from the area of the fracture. However, to be truly non-weight bearing, it is important to utilize crutches or a crutch alternative such as a knee scooter or hands free crutch. Generally, a minor fracture will take 6 – 8 weeks to heal.

Anti-inflammatory Medication – A doctor may prescribe non-steroidal anti-inflammatory drugs to help reduce pain and swelling while the fracture heals.

Unfortunately, Jones fractures can recur and take significant time to heal. If this is the case, then surgery may be required.

Surgical Treatment

Surgery to heal a Jones fracture can be recommended for many reasons. Poor blood supply to this area of the mid foot, a high likelihood of re-injury, and the severity and cause of the fracture are all taken into account when surgery is suggested. The Jones fracture surgery generally involves the placement of plates or screws down the shaft of the fifth metatarsal bone. Placing a screw in the foot holds the bone in place immediately. Bone grafts are sometimes necessary with more severe fractures but are not the most likely course of surgery. While some athletes have been known to return to full activity within 2 to 4 weeks after surgery, it is more likely that recovery will be between 6 and 8 weeks.

Recovery

With any foot injury, regardless of whether surgery has taken place, it is important to take recovery very seriously. With both surgical and non-surgical Jones fracture treatments, the recovery period is significant (generally 6 to 8 weeks), and doctor’s orders should be strictly followed.

After surgery, the doctor will usually put the foot in a cast or boot to immobilize the foot. Recovery for both methods of treatment will include a period of non-weight bearing activity when absolutely no weight can be put on the foot. Crutches will enable the patient to keep weight off the foot, but some find them to be cumbersome or even dangerous. Those patients with an active lifestyle may want to look into crutch alternatives such as a knee scooter or iWALK2.0. While both devices elevate the foot and allow non-weight bearing activity, the iWALK2.0 is the only hands free crutch alternative that enables the patient to perform day-to-day tasks while utilizing their hands and arms. It is very important that you seek a method that works best for you given your individual situation. Following non-weight bearing orders is often the most difficult but most beneficial step to a full recovery.

Jones fractures can reoccur, so it is essential to adhere to the non-weight bearing timeline prescribed by your doctor. In addition, it is often recommended that the patient not resume normal activity until a post-surgery x-ray is complete. Finally, a period of physical therapy may be required to help you improve walking functions and learn ways to put proper stress on the healing bone. To learn more about the iWALK2.0, click here.

What will my recovery entail?

Recovery time from a fractured tibia varies from person to person and is largely dependent on the severity of the break and type of treatment. A minor stress fracture to the tibia may only require a few weeks free of the activity that caused the fracture. Most fractures heal completely within 4 months. Others can take 6 months or longer to heal. The most important factors determining healing time are strictly following the doctor’s instructions and monitoring your ongoing recovery in order to avoid re-injury.

Immediately following surgery, depending on the level of swelling, you may be in a splint. Once swelling has subsided, a cast or boot may be used to support the healing bones. Your doctor may encourage some leg motion in the early recovery period to avoid stiffness. In addition, physical therapy may be prescribed while you are in your splint, cast or boot. Physical therapy will help to strengthen the surrounding muscles, prevent atrophy, and restore normal joint movement and flexibility.

A very common part of recovery from a fractured tibia is a period of time when you will not be able to bear weight on the injured limb. The period of time can last for a few weeks or up to several months, depending on the severity of your injury. A minor stress fracture may only require that you cease a certain activity for a short period of time, sometimes as little as a few weeks, but another injury may require a much longer period of non-weight bearing activity. It is very important to follow your doctor’s instructions carefully in order to have as quick a recovery period as possible.

The non-weight bearing period of your recovery will require that you use a walking aid such as crutches, a knee scooter, or hands-free crutch such as iWALK2.0.

While physicians commonly suggest traditional crutches, they can be very cumbersome to use and severely limit an active day-to-day lifestyle. A knee scooter is perceived to be easier to use, as it doesn’t require as much upper body strength or coordination to operate. However, it doesn’t function well if navigating stairs or small spaces are a part of your everyday routine. iWALK2.0, a hands-free crutch alternative, functions as an extension of the patient’s leg, and provides complete non-weight bearing mobility. Patients using iWALK2.0 find very few disruptions to their day-to-day lifestyle during their non-weight bearing period of recovery. To learn more about the iWALK2.0, click here.

Summary

Jones fractures, whether caused by overuse, stress, or acute reasons, are painful and require a significant recovery time, regardless of surgical or non-surgical treatment. Consulting a physician soon after realizing that a Jones fracture may be the cause of pain in the mid foot is extremely important and will speed overall recovery. In addition, adhering to the physician’s recommendations, regardless of their impact on your day-to-day life, is essential to the healing process and full recovery from a Jones fracture. Advancements in non-weight bearing devices, such as the iWALK2.0, can help you manage your overall recovery process and may help to eliminate the risk of an injury reoccurrence.

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