A Jones fracture is a fracture of the diaphysis

Diaphysis

The diaphysis is the main or mid section of a long bone. It is made up of cortical bone and usually contains bone marrow and adipose tissue ....

 of the fifth metatarsal of the foot

Foot

The foot is an anatomical structure found in many vertebrates. It is the terminal portion of a limb which bears weight and allows locomotion. In many animals with feet, the foot is a separate organ at the terminal part of the leg made up of one or more segments or bones, generally including claws...

. The fifth metatarsal is at the base of the small toe

Toe

Toes are the digits of the foot of a tetrapod. Animal species such as cats that walk on their toes are described as being digitigrade. Humans, and other animals that walk on the soles of their feet, are described as being plantigrade; unguligrade animals are those that walk on hooves at the tips of...

. The proximal end

Anatomical terms of location

Standard anatomical terms of location are designations employed in science that deal with the anatomy of animals to avoid ambiguities that might otherwise arise. They are not language-specific, and thus require no translation...

, where the Jones fracture occurs, is in the midportion of the foot. Patients who sustain a Jones fracture have pain

Pain

Pain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...

 over this area, swelling

Swelling (medical)

In medical parlance, swelling is the transient enlargement or protuberance in the body and may include tumors. According to cause, it may be congenital, traumatic, inflammatory, neoplastic or miscellaneous....

, and difficulty walking. The fracture was first described by British

United Kingdom

The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...

 orthopedic surgeon

Orthopedic surgery

Orthopedic surgery or orthopedics is the branch of surgery concerned with conditions involving the musculoskeletal system...

 Sir Robert Jones

Robert Jones (surgeon)

Sir Robert Jones, 1st Baronet, KBE, CB was a British orthopaedic surgeon who helped to establish the modern specialty of orthpaedic surgery in Britain....

, who sustained this injury himself while dancing, in the Annals of Surgery in 1902.

Diagnosis

A patient with a Jones fracture may not realize that it is a fracture, and could mistake it for a sprain.

The diagnosis is made with general diagnostic x-rays. These need to be taken from anteroposterior, oblique, and lateral views. They should be made with the foot in full flexion.

Treatment

If a Jones fracture is not significantly displaced, it can be treated with a cast, splint or walking boot for four to eight weeks. Patients should not place weight on the foot until instructed by their doctor. Three-fourths of fractures treated like this should heal.

In the case of acute fracture in an athlete, a dynamic compression plate can be placed on the tension side of the fracture, K-Wire with Monofiament wire in a figure 8 fashion due to the nature of a transverse fracture. Internal fixation with cortical or cancellous screw would require an oblique fracture that could be addressed through "The rule of 2's" in regards to Internal fixation with screws.

Other treatments commonly encouraged are increased intake of vitamin D

Vitamin D

Vitamin D is a group of fat-soluble secosteroids. In humans, vitamin D is unique both because it functions as a prohormone and because the body can synthesize it when sun exposure is adequate ....

 and calcium

Calcium

Calcium is the chemical element with the symbol Ca and atomic number 20. It has an atomic mass of 40.078 amu. Calcium is a soft gray alkaline earth metal, and is the fifth-most-abundant element by mass in the Earth's crust...

.

This injury must be differentiated from the physiologic developmental apophysis commonly and normally occurring at this site in adolescents. Differentiation is possible by characteristics such as absence of sclerosis of the fractured edges (in acute cases) and orientation of the lucent line: transverse (at 90 degrees) to the metatarsal axis for the fracture (due to avulsion pull by the peroneus brevis muscle inserting at the proximal tip) - and parallel to the metatarsal axis in the case of the apophysis.

Prognosis

If a Jones fracture fails to unite (malunion or non union), which is a common problem with these fractures, it can become a chronic condition. If this is the case, podiatrists will likely recommend that the patient spend more time in a cast, up to twenty weeks.

For several reasons, a Jones fracture often does not heal. The diaphyseal bone, where the fracture occurs, is an area of poor blood supply. In medical terms, it is a watershed area between two blood supplies. This makes healing difficult. In addition, there are various tendons, including the peroneus brevis and fibularis tertius, and two small muscles attached to the bone. These may pull the fracture apart and prevent healing.

Other proximal fifth metatarsal fractures

Other proximal fifth metatarsal fractures exist, although they are not as severe as a Jones fracture. If the fracture enters the intermetatarsal joint, it is a Jones fracture. If, however, it enters the tarsometarsal joint, then it is an avulsion fracture

Avulsion fracture

An avulsion fracture is a bone fracture which occurs when a fragment of bone tears away from the main mass of bone as a result of physical trauma. This can occur at the ligament due to the application forces external to the body or at the tendon due to a muscular contraction that is stronger than...

 caused by pull from the peroneus brevis. An avulsion fracture is sometimes called a Pseudo-Jones fracture or a Dancer's fracture.

External links

• Jones fracture - wheelessonline.com