Jones fracture: main symptoms and treatments

Jones fracture is one that occurs in a specific area of ​​the fifth metatarsal. This is part of a group of long bones located in the foot a little after the beginning of each toe.

Although the injury is usually very small, some anatomical features make it difficult to heal in a short period of time. Fortunately, there are several treatment options depending on the patient. If you want to know more, keep reading!

What is a Jones fracture?

It is a fracture of the proximal fifth metatarsal. The mechanisms that lead to its production are various, although one of the most common is "forced inversion" of the foot in which this region is exaggeratedly folded. It usually happens when playing sports like soccer.

Its name comes from the first person to describe this fracture, Sir Robert Jones (1857 – 1933). He was a prominent English orthopedic surgeon who created the term Jones fracture when he sustained this same injury during a dance.

Find out more: Repetitive injuries in sport: Hazard's case

Symptoms

The clinical manifestations of Jones' fracture are similar to those of other fractures, and are as follows:

• Intense pain, even without palpation of the affected area.
• Redness
• Local temperature rise.
• Swelling.
• Decreased mobility of the finger and some difficulty walking.

These can present in a variable way and depend on the severity of the fracture and the personal characteristics of each patient.

How is it diagnosed?

When going to a trauma medical service, the treating doctor will be able to make the diagnosis taking into account the data collected in the medical history and some complementary studies. Within the latter, the most important is plain radiography.

It is a simple, inexpensive method, easily accessible and emits little amount of radiation. Not only does it detect a Jones fracture, but it also it is also widely used for the vast majority of fractures. As it is an area with poor blood supply, external or internal bleeding is not usually evident.

Other fifth metatarsal fractures

If the injury does not occur at the junction of the proximal third with the middle third of the bone, it is not a Jones fracture. Therefore, there are other nearby regions that are susceptible to damage but do not have the same clinical characteristics as this condition.

This is the case of avulsion fractures. The fifth metatarsal has a small bony prominence called the tuberosity, which is related to two important structures: the lateral peroneus brevis tendon and the lateral cord of the plantar aponeurosis.

When these structures are pulled, a fracture can occur. Here, a small portion of the bone is detached as a result of the pressure exerted. This type of mechanism is different from the one that generates the Jones fracture.

How is it treated?

The doctor can resort to two treatment options depending on the clinical context of the patient: conservative or surgical. Each has its own advantages and disadvantages, and sometimes it is often a matter of controversy among specialists.

In addition, non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may be indicated to relieve pain.

Non-surgical treatment

Also called 'conservative', this treatment modality relies on immobilization of the affected area to decrease pain and swelling, and promote the union of bone fragments in a natural way.

It is a valid therapy for people who do not usually do physical activity on a regular basis and do not wish to undergo surgery. It is also a convenient option for those patients who have some type of contraindication, despite the fact that intraoperative complications in this case are few.

If you opt for this treatment, the patient could be a minimum of 4 weeks in the castAlthough it depends on the clinical evolution and the exact site of the fifth metatarsal where the fracture occurred.

Surgical treatment

This consists of the placement of a screw in the central part of the bone, which allows the separated structures to be "connected" and to favor their union in a more exact way. It is usually used in professional athletes who need to join their activities early.

According to this scientific review article (2018), it is a method that is related to a higher success rate and a lower incidence of recurrences, despite the fact that injuries to some nerves may occur during the operation.

Possible complications

Because it is an area with little blood supply, delays in bone healing. That is, the union of the different fragments separated by the fracture may take time to occur.

This also conditions other complications, like the tendency to relapse. Patients with a history of Jones fracture should take special care when engaging in physical activities, as there is a greater chance of suffering a similar injury.

Find out more: How to prevent bone problems

When to see a doctor?

Any suspected fracture should be evaluated by a trauma physician. Although Jones fracture is not a condition that usually puts the patient's life in immediate danger, it does delay diagnosis and treatment. it only increases the likelihood of complications.

Jones fracture: small but complicated

As you may have noticed throughout the article, this type of injury may take time to heal and may even require surgical treatment, of course after a specialist's evaluation.

Most of the time it occurs as a result of an accident, so there are not many effective methods to prevent it beyond having a healthy lifestyle and being careful.

In case of presenting symptoms compatible with this or any other type of fracture, it is necessary to go to a trauma service as soon as possible.