Lower Leg Injury Resource Center

Jones Fracture

Symptoms, Causes, Treatments, Surgery and Recovery

A Jones fracture, also called a fifth metatarsal fracture, is a foot injury involving the fifth metatarsal, the long bone extending along the outside of the foot and connecting to the small toe. This fracture is very common in athletes and can be caused by overuse or midfoot stress. The Jones fracture can be mistaken for a simple ankle sprain but is much more serious. If you suspect you have a Jones fracture, seek medical attention immediately.

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WHAT IS A JONES FRACTURE?

The Jones fracture is a fracture of the fifth metatarsal, the bone along the outside of the foot, and occurs at the base of the bone closest to the ankle.
There are other injuries that can impact the fifth metatarsal, such as an avulsion fracture (also known as a pseudo-Jones or dancer’s fracture), but the Jones fracture tends to be more serious.

A Jones fracture occurs where the base of the bone connects to the shaft. This area is susceptible to stress and receives less vigorous blood flow than other parts of the midfoot—both qualities that can slow or complicate the healing process.

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JONES FRACTURE CAUSES

Jones fractures are caused by overuse and repetitive stress, or by sudden trauma.

Overuse and stress: Repeated impacts can result in a hairline fracture on the fifth metatarsal that develops over time. This can be caused by walking, jumping or running and is often more prevalent in patients with high arches.

Sudden trauma: An acute foot injury such as a turned ankle or twisting fall can also cause a Jones fracture. Sudden traumatic Jones fractures tend to occur when the foot is pointed down and the ankle rolls to the outside. This type of Jones fracture frequently affects athletes and is very common among football, soccer and basketball players.

The Jones Fracture often afflicts athletes. Kevin Durant and Pau Gasol of the NBA and Dez Bryant of the NFL are well-publicized examples

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COMMON SYMPTOMS

Jones fractures produce, pain, swelling and difficulty walking. Specific Jones Fracture symptoms may include:

  • Pain on the outside of the midfoot,
  • Tenderness to pressure on the outside of the midfoot,
  • Bruising along the outside of the foot,
  • Difficulty bearing weight or walking on the affected foot,
  • Chronic ache on the outside of the midfoot.

Is it just an ankle sprain?

Jones fractures are sometimes mistaken for ankle sprains but are generally much more severe. If resting, icing and elevating your foot do not alleviate pain after a few days and you have some or all of the Jones fracture symptoms, seek medical attention immediately.

The fifth metatarsal and outside of your midfoot where the Jones fracture occurs has less vigorous blood flow than other parts of the foot, and the fracture and associated swelling can further disrupt that supply. This can prevent proper healing.

The Jones fracture can worsen if it’s not treated appropriately, especially if the fracture is due to stress or overuse. If your doctor suspects a fracture of the 5th metatarsal, he or she will examine the foot, order x-rays and determine the exact source and location of the pain.

Seeing a doctor early will determine if you have a Jones fracture and the severity of the break if you do. Early detection and corrective action will also put you on the road to recovery much quicker.

Jones Fractures Can Reoccur

Because the fifth metatarsal is prone to stress and has poor blood flow, Jones fractures are slow to heal and can reoccur, so it’s essential to adhere to your doctor’s recommendations, which will probably include six to eight weeks of non-weight bearing activity.

After you’re cleared for some level of weight-bearing activity, your doctor may also prescribe physical therapy to help you gradually weight the injured foot over time. This will help avoid reinjuring the fifth metatarsal and improve the overall range of motion, strength and functional mobility in your foot and ankle over time.

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HOW IS A JONES FRACTURE TREATED?

The Jones Fracture is a complicated injury that can take significant time to heal, and treatment will depend on the type and severity of your fracture. Treatments include non-surgical and surgical options.

Non-Surgical Treatment

Rest, Ice, Compression and Elevation: The benefits of implementing rest, ice, compression and elevation (RICE) are well established for many foot injuries, including the Jones fracture. By staying off the injured foot, icing it multiple times a day, wrapping the foot, and elevating it, you help reduce swelling and increase blood flow. This initial treatment accelerates the body’s natural healing process.

Immobilization: Jones fractures can heal if they’re protected from weight-bearing activities for a long period of time. A protective boot, cast or stiff-soled shoe can help support the foot and divert pressure away from the broken 5th metatarsal.

To completely rest the injured foot and maintain a period of non-weight bearing activity, you’ll need crutches or a crutch alternative like a knee scooter or hands-free crutch for six to eight weeks.

Anti-inflammatory Medication: Your doctor may prescribe non-steroidal anti-inflammatory drugs like ibuprofen to help reduce pain and swelling while the fracture heals.

Jones fractures can recur and take significant time to heal. If your Jones fracture is re-injured or isn’t healing properly, surgery may be required.

Surgical Treatment

Surgery to repair Jones fractures is most common in athletes or when non-surgical treatments weren’t successful. Poor midfoot blood supply, a high likelihood of re-injury, and the severity and cause of the fracture are all factors that will help your doctor determine if surgery is necessary.

During Jones fracture surgery your doctor will place plates or screws in the shaft of the fifth metatarsal that will stabilize the fracture while it heals. Unless it aggravates your foot, the hardware is not usually removed.

Bone grafts are sometimes necessary to repair severe Jones fractures but are not the most likely course of action.

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JONES FRACTURE RECOVERY TIME

Healing from a Jones fracture typically takes six to eight weeks, a lengthy recovery period necessary because of poor blood flow around the fifth metatarsal and fragility of that part of the foot.

Studies have shown, however, that devices like the iWALK hands-free crutch can stimulate lower leg muscle engagement and improve blood flow in the foot while still immobilizing it. This could speed a lengthy recovery period.

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WALKING AFTER A JONES FRACTURE

Both non-surgical and surgical Jones fracture recoveries involve a long non-weight bearing period. Your doctor will usually immobilize your foot using a cast or boot and ask you not to stress or weight your foot for six to eight weeks.

Crutches can help a patient keep weight off the foot, but some people find them cumbersome or even dangerous, so you may want to look into crutch alternatives such as knee scooters or the iWALK hands-free crutch.

Knee scooters have become popular alternatives to traditional crutches and have some mobility advantages. However, they still require use of your hands and are not well equipped for uneven terrain or stairs.

Knee scooters and the iWALK hands-free crutch both elevate the foot and facilitate non-weight bearing activity. The iWALK, however, is the only hands-free crutch available and enables people recovering from foot and ankle injuries to perform day-to-day tasks like walking the dog or carrying groceries, activities that require use of your hands and arms.

Moreover, studies show the iWALK simulates normal walking in a way that engages upper and lower leg muscles while immobilizing the foot. This boosts blood flow in the lower leg and foot, which could speed recovery times. Engaging lower leg muscles while using the iWalk also avoids muscle atrophy that’s unavoidable using traditional crutches or knee scooters.

Regardless how you choose to get around during recovery, it’s very important to find a method that works best for you. Staying off a recovering Jones fracture is one of the most important, yet challenging, parts of the recovery process. Jones fractures simply require a significant amount of rest to heal properly.

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JONES FRACTURE SUMMARY

In conclusion, the Jones fracture is a painful injury that require significant recovery time following both surgical and non-surgical treatments. Consulting a physician as soon as you suspect a Jones fracture is extremely important and will speed overall recovery. Moreover, adhering to the physician’s recommendations is essential to the healing process and full recovery from a Jones fracture surgery.

Finally, advancements in non-weight bearing devices like the iWALK hands-free crutch can help you manage your overall recovery process and may even eliminate the risk of re-injury.

 The information above is intended for informational purposes only and is not intended to prevent, treat, or diagnose any illness or disease. We aim to provide the highest quality information, so if you have any questions on the information above, we welcome your feedback!

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RESOURCES

  1. Jenna Fletcher. Everything You Need to Know about Jones Fracture. Medical News Today. 2018. https://www.medicalnewstoday.com/articles/315039
  2. UPMC Sports Medicine. Jones Fracture. https://www.upmc.com/services/sports-medicine/conditions/jones-fracture
  3. Scott M. Strayer, CPT, USAF, MC, Steven G. Reece, M.D., and Michael J. Petrizzi, M.D. Fractures of the Proximal Fifth Metatarsal. American Family Physician. 1999 May 1;59(9):2516-2522. https://www.aafp.org/afp/1999/0501/p2516.html
  4. Seth Gamradt, MD. Jones Fractures of the Foot. Hospital for Special Surgery. 2007. https://www.hss.edu/conditions_jones-fractures-of-the-foot.asp
  5. Kevin P. Smidt; Patrick Massey. 5th Metatarsal Fracture. National Center for Biotechnology Information. 2020. https://www.ncbi.nlm.nih.gov/books/NBK544369
  6. Michael Theodoulou, DPM, FACFAS, and Raffaella Pascarella, DPM. A Guide To Intramedullary Fixation Of Jones Fractures. Podiatry Today. 2018 June 20; 31(7): 18-20. https://www.podiatrytoday.com/guide-intramedullary-fixation-jones-fractures
  7. Fifth Metatarsal Jones Fracture: Care Instructions. 2020 March 2. My Health Alberta Network. https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abs0408
  8. Ken Jung, MD. Understanding the Jones Fracture. Cedars Sanai Kerlan Jobi Institute. https://kerlanjobe.org/understanding-the-jones-fracture
  9. Fractures of the Fifth Metatarsal. Foot Health Facts. American College of Foot and Ankle Surgeons. https://www.foothealthfacts.org/conditions/fractures-of-the-fifth-metatarsal
  10. Cuyler Dewar, MS, Kevin D. Martin, DO, FAAOS, DAL. Comparison of Lower Extremity EMG Muscle Testing With Hands-Free Single Crutch vs Standard Axillary Crutches. 2020 Sept 2. https://journals.sagepub.com/doi/full/10.1177/2473011420939875