The Jones fracture story starts simply enough. Sir Robert Jones, the late 19th century Welsh orthopedic surgeon integral to the establishment of orthopedic surgery in Great Britain, was dancing, presumably at a party. During a twirl or hop, Jones hurt his foot and eventually hobbled home.
The next morning, Jones examined his foot. He was sure he would discover a damaged tendon but was surprised to find the tendon in good health. Further search showed no signs of bone fracture, at least not that Jones could detect via physical examination.
After months of hobbling about, Jones enlisted the help of a colleague, Dr. David Morgan, to perform an X-ray. The X-ray showed a fracture above the base and before the shaft of the fifth metatarsal, attached to the pinky toe. After finding similar fractures on other patients, each a result of cross-strain rather than blunt trauma, Jones wrote a paper. The name stuck.
What Is a Jones Fracture?
While a Jones fracture is the most serious type of fracture that can occur to this particular bone, it is also the most common. One of the reasons it is so common is because the fracture most often occurs because of stress caused by repeated motion. Though trauma to the foot can break the bone, this happens less often.
The fracture occurs on the fifth metatarsal, which is attached to the smallest toe on the foot. Metatarsals are long bones that travel across the top of the foot, connecting the ankle to the toes. There are five in total. Each has a base near the heel, a shaft, neck and head. Metatarsals assist with balance while standing, walking and running. Because they are so heavily used, they are prone to injury.
The fifth metatarsal is a bit different from the rest. Because of its location on the outside of the foot, its base is a bit bigger than its counterparts' bases are. A Jones fracture occurs between the base and shaft, an area called the metaphyseal-diaphyseal junction. Sufferers can expect a slightly longer period of healing when compared to the best way to treat a metatarsal fracture. This is due to the region receiving less blood than other areas of the foot.
How Do I Know if I Have a Jones Fracture?
There are three main symptoms associated with a Jones fracture, though the same symptoms are indicative of other injuries. The first is relieving wrist pain and swelling on the outside of the foot, near the little toe. Bruising often accompanies pain. Together, they lead to difficulty walking, something beyond a sore foot.
Symptoms may come on suddenly, especially if your fracture is the result of trauma. They can also occur gradually, as the bone breaks slowly due to stress.
A Jones fracture is one of a several fractures that can occur to the fifth metatarsal. Pain, swelling and bruising could be the cause of a different fracture. Two of the more common fractures are:
- Avulsion fracture: If your fracture is the result of or accompanies an ankle sprain, you most likely have an avulsion fracture. The break occurs at the base of the fifth metatarsal and happens when tendons or ligaments are pulled beyond their capacity. Displacement rarely occurs.
- Spiral or oblique shaft fracture: Similar to a Jones fracture, this break is the result of stress or trauma. It is an unstable break and may cause bone displacement.
How Soon Should I See a Doctor?
While experts do not consider a Jones fracture an emergency, there are times when it is imperative you take a trip to the ER if any of the following symptoms occur:
- Numbness or tingling in the leg, ankle or foot
- Purple skin on the leg or foot
Otherwise, elevate your foot, try your best to stay off it, and make an appointment with an orthopedic specialist as soon as possible. The doctor can then exam your foot to make sure you have a Jones fracture.
During your examination, the doctor may ask you how you hurt your foot or when you first felt pain in the affected region and will exam the area by pressing and probing the tendons and bones. The doctor will likely order X-rays or another imaging study to verify the diagnosis. Once the doctor has a diagnosis, you can discuss next steps and receive a treatment regime or you can also read the guide to groin pulls.
How Do You Treat a Jones Fracture?
The break is such a tiny thing, but for a tiny thing, it can cause a lot of pain and take a long time to heal. For this reason, a smart treatment plan that a patient diligently adheres to is the key to success. As stated above, even before you see a doctor, you can begin treating the injury.
The best course of immediate action is to follow the RICE method. RICE is an acronym that stands for Rest, Ice, Compress and Elevate. Try to stay off the injured foot as much as possible and apply a cold compression and ice to reduce swelling and treat the pain. Elevation will also help bring down any swelling. Note that this is not a treatment plan that will lead to recovery, but a way to manage the injury prior to seeing a specialist.
Once you see a doctor and the doctor makes a diagnosis, the most likely course of treatment will be placing the injured foot in a cast or boot. There are some instances when surgery is a possibility. Your doctor will determine whether you are a candidate for surgery based on your activity level, how bad the break is and your overall health.
Most doctors also suggest getting used to the cast, too. Since healing a Jones fracture can take a long time — and sometimes longer than first diagnosed — patients can expect to wear a cast beyond the original end date they were quoted.
In some cases, surgery is needed to heal the fracture. Surgery does not speed up recovery, either, according to a number of studies. Some fractures may not require surgery. In these cases, your orthopedic specialist may prescribe one of two treatment methods.
With the first, immobilization, the doctor will try to keep your foot immobile, likely using a cast or boot. During treatment, you will likely need crutches and will have to avoid placing weight on your foot for a period.
Bone stimulation, the second method that may be used, uses a pain-free external device to help speed healing time. Doctors often attempt bone stimulation when immobilization fails.
What Does Surgery Entail?
If you are young or an athlete, or your job requires a fair amount of physicality, your doctor may refer you to a surgeon. A surgeon will then assess the best way to treat your Jones fracture and jumpers knee.
Surgery often entails repair via a screw or plate reinforcing the metatarsal. The goal is to secure the foot, since a Jones fracture heals slowly and stubbornly, and avoid re-injury. The surgery is conducted outpatient. If you are a candidate for the procedure, you will be able to go home the same day.
If you undergo the surgery, it will begin with a local anesthetic. In some cases, for some patients, a general anesthetic may be used. The surgeon will cut a small incision in your foot, by the bone, and will use X-rays to guide screw or plate placement. By inserting a screw, the surgeon can pull the fracture together to join the bone.
A Jones fracture is a pesky injury, too. Limited blood flow to the area makes it a candidate for poor healing and re-injury. Nearly 20 percent of Jones fractures do not heal without surgery. Because it is easy to re-injure the metatarsal and wind up with another fracture, some patients may eventually require bone grafting.
How Long Does It Take To Heal?
The stubbornness of a Jones fracture is well documented. Because it can be hard to manage, healing times for patients vary. Other factors play a part as well, including fracture severity, treatment method for and the patient’s overall health and willingness to adhere to a treatment plan.
In general, Jones fracture and clavicle fracture surgery patients cannot put pressure on the foot for a couple days following the surgery. Afterward, doctors may allow patients to place weight on their heel. Around six weeks, a weight-bearing walking boot can be used. It will take upwards of four months before patients can return to normal activity, including sports. Physical therapy like may occur after this four-month period, as well. These are not definitive times. Bone graft patients may take longer and less serious Jones fractures may take a shorter period.
Patients can follow a few steps to help ensure a quick recovery. Those include keeping weight off the foot, elevating the foot whenever sitting or lying down, regularly icing the injured area, and following the doctor’s recommendations as closely as possible. Patients can manage pain with ibuprofen.
Jones fracture, while small, can be both painful and a nuisance. This injury can take a long time to heal and is prone to re-injury if patients do not follow treatment plans or if the injury is particularly stubborn or severe. If patients follow their treatment plan, however, they can return to full activity within a few months.