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Forefoot Injuries INJURIES

Jones Fracture Surgery: Who Needs It and What It Entails

Jones Fractures are common injuries that occur in the foot. They can cause pain and limit your activities significantly. In many cases, Jones fractures require surgery. Surgery can help fix the fracture and allow you to return to your activities sooner. 

In this article, we’ll discuss when you would need the Jones fracture surgically repaired, and what the surgery entails. You’ll also learn what to expect during the recovery process. 

What Is a Jones Metatarsal Fracture?

A Jones fracture is a fracture that occurs in the fifth metatarsal base. The fifth metatarsal bone is the long bone that is located on the outer aspect of the foot. In a Jones fracture, the fracture occurs at the base (bottom part) of the fifth metatarsal. 

Twisting injuries of the foot and falls can lead to Jones bone fractures. A Jones stress fracture can occur from repetitive stress being placed on the fifth metatarsal bone, causing it to crack. 

When Do You Need Surgery for Jones Metatarsal Fractures?

If you have a Jones fracture and the fracture is displaced, surgery will be required. Displacement of a fracture is when the fracture fragments are shifted out of place. When the fracture fragments are not aligned, they will not heal in the proper position. This can lead to continued pain and deformity. 

In some athletes, even nondisplaced Jones metatarsal fractures should be repaired surgically. This is because the blood supply in the area of the Jones fracture is poor. This makes healing difficult. 

Athletes who need to be able to recover quickly would benefit from surgical repair. 

Early surgical fixation of acute Jones fractures has been shown to result in shorter times to return to athletics compared with cast treatment (1).

Another reason why surgery would be necessary is if the fracture fails to heal with non-surgical treatment. If the fracture has not healed after two months, your doctor will suggest surgery.

Some people are at high risk of not healing the fracture site without surgery due to health conditions like diabetes and osteoporosis. These people would benefit from surgical repair of the fracture. 

What Does a Metatarsal Jones Fracture Surgery Entail?

Surgery for Jones fracture would be done in the outpatient setting. This means that you can go home the same day after the surgery. 

Surgery would be done under anesthesia. You will be sleeping during the entire procedure. The surgery will take 1 to 2 hours to complete. 

Internal Fixation of Jones Foot Fractures

During the surgery, your doctor will make an incision along the fracture site. They will then realign the broken fracture fragments and hold them in place using a large screw. 

In some cases, plates and screws may be used to hold the fracture in place. They will then close the surgery site using stitches. Your doctor will then apply a cast or splint on your leg. 

Bone Grafting

Your surgeon may insert a bone graft in the area of the fracture to help promote fracture healing. An autogenous bone graft may be used. This is when a graft is usually taken from your heel bone and inserted directly into the fracture site. 

In some cases, an allograft bone graft may be used. This is when a piece of bone from a donor (cadaver) is inserted into the fracture site.  

Both grafts can help support the bone and promote bone healing. 

With an autogenous bone graft, the risk of rejection of the graft is low. However, the downside of using an autogenous bone graft is that it requires another surgery and another incision to harvest the graft. This can increase healing time. 

This can be avoided by using an allograft bone graft. However, an allograft bone graft does have a small chance of becoming infected or undergoing rejection from the body.   

What Is the Healing Time for Jones Foot Fractures?

The healing time after Jones fracture surgery can take anywhere from 8-12 weeks. It will depend on the severity of the injury and the person’s general health. 

After surgery, your doctor will recommend that you stay non-weight bearing in a cast for 6 to 8 weeks followed by weight-bearing in a cast walker for an additional 4 weeks. 

Your doctor will then suggest you start physical therapy three times a week for one month to help regain strength in your leg, improve your range of motion, and improve balance. 

Complications of Jones Fracture Surgery

  • Infection: Infection of the incision site is a complication that can occur from the surgery. Signs of inflection include redness, warmth at the incision site, and pain. Treatment options include oral or IV antibiotics.
  • Nonunion: Even after surgical repair, a non-union of the fracture site can occur. This is when the fracture does not heal properly after 3 months. Treatment for non-union includes using an external bone stimulator to help the bone heal. In some cases, another surgery may be needed to fix the non-union by inserting a bone graft in the fracture site. 
  • Malunion: A malunion is when the fracture is fixed but in the wrong position. This is a complication that can occur from the surgery. Treatment of this would involve another surgery to reposition the bone in the correct position.
  • Nerve damage: Nerve damage after surgery may be temporary or permanent. Symptoms could include numbness, tingling, and burning in the foot. Your doctor will prescribe medications and suggest physical therapy to help manage symptoms.
  • Swelling: Although some swelling is expected after foot surgery, prolonged swelling may occur. Your doctor will recommend that you elevate your leg and wear compression stockings to reduce swelling.

Conclusion

Metatarsal Jones fracture surgery is necessary when fracture displacement is present or the individual has not responded to non-surgical treatment options. Surgery is an effective way in treating fracture and can help patients return to their activities sooner.  

If you think you may have sustained a Jones fracture, make sure you contact your local healthcare provider. 

Related articles:

Jones Fracture Diagnosis: How To Identify This Common Foot Injury

Pediatric Jones Fractures: Causes, Symptoms & Treatment

Jones Fractures Healing Time: How Long Does It Take To Heal the Fracture?

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References

  1. Mologne TS, Lundeen JM, Clapper MF, O’Brien TJ. Early screw fixation versus casting in the treatment of acute Jones fractures. Am J Sports Med. 2005 Jul;33(7):970-https://pubmed.ncbi.nlm.nih.gov/15888715/
  2. Chloros GD, Kakos CD, Tastsidis IK, Giannoudis VP, Panteli M, Giannoudis PV. Fifth metatarsal fractures: an update on management, complications, and outcomes. EFORT Open Rev. 2022 Jan 11;7(1):13-25. https://pubmed.ncbi.nlm.nih.gov/35073515/

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Vaishnavi Bawa
Dr. Vaishnavi Bawa is a Podiatrist who specializes in treating foot and ankle pathology. LifesLittleSteps mission is to educate the public about foot health in an easy-to-understand manner using evidence-based medicine.
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