Distinguishing Jones and Proximal Diaphyseal Fractures of the Fifth Metatarsal. Chuckpaiwong B, Queen R, Easley M, Nunley J. Internal fixation and even bone grafting may be required in cases of non-union, or where the fracture is significantly displaced. The outcomes are similar with almost 100% union rates 7. Management includes either intramedullary screw fixation or open reduction and internal fixation (ORIF is also the main management option as a salvage procedure when there is non-union following screw fixation) 7. Operative management is indicated in patients that are elite or competitive athletes or in non-operatively managed fractures when delayed union has occurred 7,8. In contrast to avulsion fractures, Jones fractures are prone to non-union (with rates as high as 30-50%) and almost always take longer than two months to heal 2.ĭisplacement of the fracture can increase with persistent weight-bearing, therefore, immobilization is important as part of the initial therapy, with a non-weight bearing cast for 6-8 weeks. Indications for non-operative management include undisplaced fractures and fractures in patients with limited activity (i.e. Jones fracture is located at the metadiaphyseal junction, approximately 2 cm (1.5-3 cm) from the tip of the 5 th metatarsal, and has a predominantly horizontal course. Radiographic features Plain radiograph/CT The fracture is believed to occur as a result of significant adduction force to the forefoot with the ankle in plantar flexion 5. It is a transverse fracture at the base of the fifth metatarsal, 1.5 to 3 cm distal to the proximal tuberosity at the metadiaphyseal junction, without distal extension.
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