5th Metatarsal Fractures or Jones Fractures explained in English

You were dancing or slipped or stepped down wrong and now the doctor tells you that snap you heard was your fifth Metatarsal fracture.  Your first question is, what caused it?  There are two primary causes, one is that it is at its heart a stress fracture, that so much weight an activity take place on the bone causing the fifth Metatarsal to fracture.  The other theory is the avulsion fracture as a muscle the Peroneus Brevis inserts on the fifth metatarsal and a sudden jerk by the tendon can cause the fracture.  It does not matter how you got here, really it just matters that you are here.

If you have an avulsion fracture you are lucky, most likely a cast or Walking boot for a couple of weeks then a surgical shoe.  You may even not have to go on crutches.  These fractures tend to heal up on their own without too much difficulty occasionally they go onto surgery but that is rare.

The Jones fracture however is a completely different type of fifth metatarsal fracture.  The Jones fracture is a little way up into the shaft of the bone.  Unfortunately the Jones fracture also is an area of the bone which obtains very little blood supply, so these can have difficulty healing.  Jones fractures are synonymous with going on to non-union (which means the fracture did not heal).  If you go to ten different doctors, you are liable to get different treatment plans.  But, generally they boil down to this, some doctors believe, that Jones fractures need to operated on immediately, others believe Jones fractures need six weeks of non weight bearing on crutches.

Why Surgery? You look at the X ray and the bone does not look displaced, that is true.  But there is a gap there and the screw can give extra compression across the fracture line of the fifth metatarsal, which can expedite healing a lower the complication rate.  If you are young, active or an athlete this would be the treatment best suited for you.  Some doctors will even will not put you on crutches and you can weight bear quickly.

The other option is the cast or  Air Walking Boot .  This requires six weeks of no weight on the foot.  This tends to be successful at a decent rate (not as successful as surgery).  The key to this is, obviously if it does not work you can have the fracture repaired later.  This is ideal for middle aged, or people who just want to avoid surgery.  It does mean crutches or you can use this as an alternative to crutches:

What happens if this does not work?  As I said before Jones fractures have a high non union rate.  Much higher in people that smoke. Then you will either have a bone stimulator which encourages bone to grow and heal, or you will have to have surgery with a bone graft both are unappealing options.  But options that have to be considered on occasion.  So, good luck and I hope this article helped you.