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Fifth Metatarsal Fractures: Jones Fracture

Fifth Metatarsal Fractures: Jones Fracture

What are Fifth Metatarsal Fractures?

The metatarsal bones are the long bones in your feet. There are five metatarsal bones in each foot. The fifth metatarsal is the long bone that is located on the outside of the foot and connects to the small toe. The fifth metatarsal bone is more commonly fractured. Fractures of the 5th metatarsal are difficult to treat. Often they require surgery as their blood supply is so poor. NYU surgeons were the first in the world to report on a new intramedullary screw in association with CBMA to augment healing. 

There are two types of fractures that often occur in the fifth metatarsal:

  • Avulsion fracture: a piece of the bone is pulled off the main portion of the fifth metatarsal by the tendon that attaches to this region.
  • Jones fracture: involves fracture in a small area of the fifth metatarsal that receives limited blood supply. It can either be a stress fracture (a small hairline break that occurs over time) or an acute (sudden) break. These fractures are less common than those of avulsion fractures and may take longer to heal. 
  • Other fractures such as mid-shaft fractures (dancer’s fracture) and fractures of the metatarsal head and neck may occur in the fifth metatarsal. 

Causes

Overuse, repetitive stress and trauma are the most common causes of Jones fractures. Patients who sustain a Jones fracture have pain, swelling, tenderness, and bruising over the outside area of their foot. They may also have difficulty in walking. 

Diagnosing will require X-Ray.

Treatment: Surgery vs. Non-Surgical

  • Zone 1: non-displaced fracture, typically heals in a CAM Boot over 4-6 weeks
  • Zone 2&3: fractures usally are best treated with surgery. The most common form of surgery is an IM Screw. Dr. Kennedy’s team wrote the 1st paper showing how athletes returned to sports faster when bone marrow aspirated stem cells are used with the surgery. 

Surgery may include placing a screw to stabilize the fractured bone, and hold it securely in place while healing occurs, stem cells from the iliac crest will be used to stimulate a quicker healing response. Your doctor will discuss the type of procedure that may be needed for your condition.
 

Articles:

Percutaneous internal fixation of proximal fifth metatarsal jones fractures (Zones II and III) with Charlotte Carolina screw and bone marrow aspirate concentrate: an outcome study in athletes

The lateral dorsal cutaneous branch of the sural nerve: clinical importance of the surgical approach to proximal fifth metatarsal fracture fixation

The effect of concentrated bone marrow aspirate in operative treatment of fifth metatarsal stress fractures; a double-blind randomized controlled trial

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