What Is a Jones Fracture?
A Jones fracture is a fracture that occurs in the fifth metatarsal bone. The fifth metatarsal bone is the long bone located on the outer aspect of the foot. The fifth metatarsal connects the pinky toe to the midfoot.
A “Jones fracture” is a fracture that occurs at the base of the fifth metatarsal.
How Are Jones Fractures Treated?
The treatment of Jones bone fractures depends on the type of fracture, the fracture displacement, and the individual.
If the Jones fracture is broken but the fracture fragments remain in proper alignment, it can be treated non-surgically.
If the Jones fracture fragments are broken and are not in proper alignment, then surgery would be needed.
Immobilization of a Jones fracture is critical for it to heal.
Bone healing will take six to eight weeks minimum.
You will need to remain off of your foot in a cast or cast boot for six to eight weeks to allow for the bone to heal.
Your doctor will obtain x-rays in the office every three to four weeks to assess bone healing. If the bone has healed after 8 weeks, you can return to wearing athletic shoes and resume your normal activities.
Immobilization is a low-risk treatment that will allow your Jones fracture to heal in most cases.
The problem with immobilization for several weeks is that it can feel inconvenient for people. Not only that but having your leg immobilized in a cast for several weeks can cause your foot and leg muscles to become weak.
Your doctor will suggest you complete physical therapy 3 times a week for 1 month before resuming your normal activities. The goal would be to regain muscle strength and improve the range of motion.
In some cases, despite staying off of the foot for several weeks, the Jones fracture may not heal. This is because of the lack of blood supply at the 5th metatarsal base. In these cases, your doctor may suggest using a bone stimulator to help heal the bone.
A bone stimulator is a device that you wear on your foot that sends low-intensity ultrasound waves or electromagnetic fields to the bone. This stimulates the cells in the bone to speed up the healing process.
Using a bone stimulator is non-invasive. You will need to use it for an hour a day.
The downside is that bone stimulators are often expensive and may not always be covered by insurance. Ask your foot doctor if this is an option for you.
Complications of Nonsurgical Treatment for Jones Fractures
One of the main complications of a nonsurgically treated Jones fracture includes a non-union of the fracture site.
A nonunion is when the fracture doesn’t heal. Due to the poor blood supply of the bone at the fifth metatarsal base, nonunion rates after nonsurgical treatment of Jones fracture are up to 21% (1).
Also in some people, there may be delayed healing of the fracture. People who smoke or have a history of diabetes may have a harder time healing the fracture. This is because the amount of oxygen reaching the tissues/bone is reduced.
Occasionally, a malunion may occur as well. This is when the fracture heals in the wrong position.
Nonsurgical treatment for Jones fractures typically have longer recovery rates compared to surgical treatment.
When Would Jones Fracture Surgery Be Needed?
If the Jones fracture does not heal after 8 weeks with non-surgical treatment, your doctor may suggest surgery to help heal the Jones fracture.
During surgery, your doctor will fix the fracture and secure the fracture in place by inserting a screw through the fracture site. A bone graft may be inserted into the fracture site to help heal the bone.
When Can You Drive After a Jones Fracture?
The amount of time it takes before you can drive will depend on which foot is affected, and the severity of the fracture.
If you have fractured your left foot, and are not taking any narcotics, it’s generally okay to start driving 2 to 3 weeks after you sustain the fracture.
If you have fractured your right foot, it’s best to wait 6 to 8 weeks before operating a vehicle. The bone needs to be healed before you can safely drive.
It is unsafe to drive with a cast on. In addition, a normal range of motion of the foot and ankle is necessary to be able to drive comfortably and safely. You should always consult with your foot doctor about when it is okay to resume driving.
Should You Sleep With a Cast Boot on Your Leg?
If possible, you should sleep with a cast boot on your leg while the fracture is healing. The cast boot will protect your foot and leg and prevent further disruption of the fracture site.
What Are the Side Effects of Walking Boot?
Wearing a cast boot for prolonged periods of time can cause skin irritation, stiffness of the ankle and foot, and muscle weakness. Speak to your foot doctor on how you can pad the cast boot to make it feel more comfortable. To help improve muscle strength, physical therapy will be needed.
What Should You Not Do in a Walking Boot?
While the Jones fracture is healing, avoid high-impact activities such as prolonged walking and running. Avoid walking on uneven surfaces. Do not remove your cast boot unless you have been cleared to do so by your foot doctor.
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- 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/
- Bishop JA, Braun HJ, Hunt KJ. Operative Versus Nonoperative Treatment of Jones Fractures: A Decision Analysis Model. Am J Orthop (Belle Mead NJ). 2016 Mar-Apr;45(3):E69-76. https://pubmed.ncbi.nlm.nih.gov/26991586/
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