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Forefoot Injuries INJURIES

Untreated Jones Fractures: Understanding the Causes, Symptoms & Risks

Jones fractures are fractures that occur at the base of the fifth metatarsal bone in the foot. The fifth metatarsal bone is the bone on the outer aspect of the forefoot. Jones fractures are often treated non-surgically or surgically.

It’s important to diagnose and treat the fracture early to help minimize risks and allow for a quick recovery. Untreated fractures can cause chronic pain, disability, and limitations in activity.

What Causes A Jones Metatarsal Fracture in the Foot?

Jones fractures occur from a twisting injury to the foot. This can occur during certain sports such as basketball, soccer, football, and hockey. The rotational force can cause the fifth metatarsal bone to bend and break. 

A true Jones fracture occurs at the fifth metatarsal base. Unfortunately, this is the area where the blood flow to the bone is poor. This can lead to delayed fracture healing. 

Jones fractures differ from avulsion fractures, which also occur at the fifth metatarsal base. Avulsion fractures happen when a small piece of bone breaks off where the tendon or ligament attaches to the bone.

A Jones fracture occurs further up in the fifth metatarsal base at the metaphyseal-diaphyseal region. 

Jones Stress Fractures

Jones fractures can also occur from chronic stress on the 5th metatarsal bone. Activities like running, jumping, and marching can place excess stress on the fifth metatarsal, causing the bone to crack. This is known as a Jones stress fracture

Certain foot structures can increase the risk of developing a Jones stress fracture.

People with high arches and a long fifth metatarsal bone are at increased risk for developing a Jones stress fracture.

Since stress fracture symptoms can occur gradually, many people seek treatment late. This can delay healing due to a lack of immobilization. 

Symptoms of a Jones Fracture

The symptoms of a Jones fracture include pain and swelling on the outside of the foot. You may also have difficulty bearing weight on the affected foot. If you experience any of these symptoms, it’s essential to seek medical attention as soon as possible.

Diagnosing a Jones fracture

Your foot and ankle surgeon will diagnose a Jones fracture by taking a history of your injury and performing a physical examination of your foot. Your surgeon may also order x-rays to confirm the diagnosis.

Treatment Options for Jones Fractures

Treatment for a Jones fracture will depend on the severity of the fracture as well as the person’s activity level. In many cases, non-surgical treatment options may be effective in helping the metatarsal fracture heal. However, in some cases, surgery may be needed to repair the bone.

Non-Surgical Treatment

If you have a Jones fracture that is nondisplaced, meaning that the fracture is broken but the fracture fragments are well-aligned, your doctor will suggest immobilization

You will need to stay non-weight-bearing in a cast or a cast boot for 6-8 weeks minimum to ensure that the fracture heals. Due to the poor blood supply at the fifth metatarsal head, in some cases, Jones fractures can take up to 20 weeks or more to heal (1).

Your doctor will order x-rays every 3 to 4 weeks to ensure that the fracture is healing appropriately.

Jones Fracture Surgery

If the Jones fracture is displaced, meaning that the fracture fragments are shifted, your doctor will suggest Jones fracture surgery to repair and realign the fracture. 

In some cases, even if the fracture is nondisplaced, your doctor may suggest surgery.

Say you are an athlete who must return to play quickly; your doctor will suggest surgery because this will allow you to return to play sooner. 

During surgery, your doctor will repair and stabilize the fracture site using plates and screws.

You will have to stay off of your feet for six to eight weeks after surgery until the bone is healed.

Untreated Jones Fractures Can Lead to Long-Term Problems

When left untreated, Jones fractures can cause long-term complications that can affect the person’s ability to walk and their quality of life. 

Due to the poor blood supply at the fifth metatarsal base, one of the most common complications is a delayed or non-union of the fractured bone. This means that the bone does not heal properly or does not heal at all, which can result in chronic pain, instability, and a higher risk of re-injury. 

In severe cases, surgery may be required to correct the problem. Your doctor will repair the non-union site by inserting a bone graft into the area to help the fracture heal. 

Another complication is a malunion. This is when the bone heals but is in the wrong position. This can cause continued pain and deformity of the foot. 

Untreated Jones fractures can also cause arthritis. Arthritis can develop causing pain and stiffness in the joints of the foot.

Can You Have Jones Fracture Pain Years Later?

If the Jones fracture is left untreated, it can cause chronic pain years later. When a fracture is unhealed, it can cause scar tissue to develop and inflammation. This can be painful and cause foot swelling. Not only that, nerves that run adjacent to the fracture can become damaged and cause pain themselves. You may experience numbness/tingling/burning along the fracture site. 

How to Increase Blood Flow to a Jones Fracture

Exercise can help increase blood flow to the area of the fracture site by promoting muscle activity and encouraging fluid movement to the tissues.  

Eating a healthy diet that consists of leafy green vegetables and protein can also help support bone health. 

Adequate Vitamin D levels are important to help heal fractures in the foot (2). If you are deficient in Vitamin D, talk to your doctor about starting a Vitamin D and Calcium supplement.

Conclusion

In conclusion, a Jones fracture is a serious injury that can have long-term consequences if left untreated. If you suspect that you may have a foot or ankle injury, it is important to seek medical attention right away to ensure proper diagnosis and treatment. 

Related articles:

Jones Fractures in Athletes: Risk Factors & Recovery For the Athlete

Jones Fracture or Peroneal Tendonitis: Understanding Both Foot Injuries

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References

  1. Japjec M, Starešinić M, Starjački M, Žgaljardić I, Štivičić J, Šebečić B. Treatment of proximal fifth metatarsal bone fractures in athletes. Injury. 2015 Nov;46 Suppl 6:S134-6.https://pubmed.ncbi.nlm.nih.gov/26563480/
  2. Eschle D, Aeschlimann AG. Is supplementation of vitamin d beneficial for fracture healing? A short review of the literature. Geriatr Orthop Surg Rehabil. 2011 May;2(3):90-3.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3597312/
  3. Song, L. (2022). Function and application of stem and progenitor cells in bone, cartilage and disc during regeneration and degeneration. Journal of Healthcare Engineering, 2022, 5372229.
  4. Albloushi M, Alshanqiti A, Qasem M, Abitbol A, Gregory T. Jones type fifth metatarsal fracture fixation in athletes: A review and current concept. World J Orthop. 2021 Sep 18;12(9):640-650.

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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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