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Forefoot Injuries INJURIES

Pediatric Jones Fractures: Causes, Symptoms & Treatment

What Is a Jones Fracture?

A Jones fracture is a fracture that occurs in the fifth metatarsal bone of the foot. The fifth metatarsal bone is located between the pinky toe and the midfoot. The location where the Jones fracture occurs is at the fifth metatarsal base (bottom portion of the bone). 

pediatric Jones fracture is when the fracture occurs in a child. 

Although rare, Jones fractures can occur in children who are active in sports and other physical activities.

Causes of a Pediatric Jones Fracture

Pediatric Jones fractures can occur from twisting injuries, but can also occur from sudden blunt force impact to the foot. Oftentimes, these foot fractures occur after landing awkwardly on the foot when walking or running. They can also occur during sports that involve cutting motions such as soccer and basketball.

Stress fractures can occur due to repetitive stress on the fifth metatarsal bone. Many activities such as running, marching, jumping, and even walking can cause these fractures. 

Certain foot structures can increase the risk of developing a Jones fracture. If the child has a high arch, this creates excess stress to be placed on the outside of the foot when walking/running. This can make them more prone to developing a Jones fracture. 

Children with low vitamin D levels also have an increased chance of developing a fracture (1).

Symptoms 

If your child is experiencing pain or discomfort in the midfoot, it’s important to pay attention to the symptoms that they may be experiencing. Children often have difficulty expressing where their pain is. 

Acute Jones fractures and stress fractures symptoms can appear slightly different. 

By understanding the symptoms, you can take the appropriate steps to seek medical treatment.

Symptoms of acute Jones metatarsal fractures include: 

  • Immediate pain in the foot
  • Pain and swelling in the midfoot
  • Bruising in the foot
  • Inability to bear weight on the affected foot
  • A visible foot deformity may be present
  • Numbness/tingling may be present in the foot due to nerve damage

Symptoms of Jones stress fractures include: 

  • Foot pain that worsens gradually
  • Swelling in the foot
  • Bruising in the foot
  • Inability to bear weight on the affected foot

How Are Pediatric Jones Fractures Diagnosed?

If you suspect that your child has a Jones fracture, you should visit your local foot doctor’s office or go to the emergency department. Your doctor will order x-rays of the foot to diagnose the Jones fracture

In the case of a true Jones fracture, the fracture will be located 1.5 cm from the 5th metatarsal cuboid joint. This is important to be aware of because the blood supply in this area is poor, unlike in the case of fifth metatarsal avulsion fractures.  

Your doctor will be checking to see if the fracture fragments are shifted or in proper alignment.

If the Jones fracture is not immediately visible on an x-ray, your doctor may choose to order a Magnetic resonance imaging scan (MRI) or Computed Tomography scan (CT). These are advanced imaging scans that can provide detailed images of the fracture as well as any soft tissue damage and toe fractures.

How Are Pediatric Jones Metatarsal Fractures Treated?

Non-operative Treatment

If the Jones fracture is in proper alignment, your doctor will recommend immobilizing the fracture. The child would need to stay off of their foot for 4 to 6 weeks before transitioning into full weight bearing in an athletic shoe. 

In the case of a stress fracture, your doctor may allow the child to bear some weight in a walking cast for 4 to 6 weeks before transitioning into athletic shoes.

The child will be advised to rest and elevate the foot to help reduce pain and swelling. Anti-inflammatory medications may be prescribed to help manage pain and inflammation. 

Operative Treatment

If the pediatric Jones fracture is severe and the fracture fragments are shifted, your doctor may recommend that the child gets surgery to realign the bones and stabilize the fracture site using plates and screws. 

The child will need to stay non-weight bearing in a cast or splint for 4 to 6 weeks after surgery before transitioning to athletic shoes. 

Your doctor may recommend that the child undergoes physical therapy for a month after surgery to help improve range of motion, flexibility, and balance.

When Should You Call Your Doctor for Help?

If your child experiences any of these symptoms after surgery, you should call your doctor:

  • The leg cast feels too tight
  • Pain that does not improve with pain medications
  • Your child has a fever
  • Your child’s toes are discolored
  •  Your child feels unwell
  • Chest pain
  • Difficulty breathing
  • Calf pain
  • Loss of consciousness

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

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References

  1. Assaf E, Mohs E, Dally FJ, Hetjens S, Gravius S, Darwich A. Vitamin D level and low-energy fracture risk in children and adolescents: a population-based case-control study of 45 cases. J Pediatr Orthop B. 2023 Feb 8.https://pubmed.ncbi.nlm.nih.gov/36756947

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The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

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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