Jones fracture
Updates to Article Attributes
A Jones fracturefractures occur at the base of the fifth metatarsal.
Pathology
It is a transverse fracture at the base of the fifth metatarsal, 1.5 to 3 cm distal to the proximal tuberosity at the metadiaphyseal junction, without distal extension. These should not be confused with the much more common avulsion fracture of the base of the 5th metatarsal.
Mechanism
The fracture is believed to occur as a result of significant adduction force to the forefoot with the ankle in plantar flexion 5.
Radiographic features
Plain film / CT
A Jones fracture is located at the metadiaphyseal junction, approximately 2cm (1.5 - 3cm-3cm) from the tip of the 5th metatarsal, and has a predominantly horizontal course. It should not extend distally, nor should it extend to involve the articular surfaces.
Treatment and prognosis
In contrast to avulsion fractures, Jones fractures are prone to non-union (with rates as high as 30-50%) and almost always take longer than 2two months heal 2.
As displacement of the fracture can be increased with persistent weight bearing, immobilization is important as part of the initial therapy, with a non-weight bearing cast for 6-8 weeks.
Internal fixation and even bone grafting may be required in cases of non-union, or where the fracture is significantly displaced.
Etymology
It was first described by Sir Robert Jones in 1902 3.
Differential diagnosis
A number of fractures occur at the base of the 5th metatarsal (see fractures of the proximal fifth metatarsal) as well as entities which mimic fractures. These include:
-<p>A <strong>Jones fracture</strong> is a transverse fracture at the base of the fifth metatarsal, 1.5 to 3 cm distal to the proximal tuberosity at the metadiaphyseal junction, without distal extension. These should not be confused with the much more common <a href="/articles/avulsion-fracture-of-the-5th-metatarsal-styloid">avulsion fracture of the base of the 5<sup>th</sup> metatarsal</a>.</p><h5>Mechanism</h5><p>The fracture is believed to occur as a result of significant adduction force to the forefoot with the ankle in plantar flexion <sup>5</sup>.</p><h4>Radiographic features</h4><h5>Plain film / CT</h5><p>A Jones fracture is located at the metadiaphyseal junction, approximately 2cm (1.5 - 3cm) from the tip of the 5<sup>th</sup> metatarsal, and has a predominantly horizontal course. It should not extend distally, nor should it extend to involve the articular surfaces. </p><h4>Treatment and prognosis</h4><p>In contrast to avulsion fractures, Jones fractures are prone to non-union (with rates as high as 30-50%) and almost always take longer than 2 months heal <sup>2</sup>. </p><p>As displacement of the fracture can be increased with persistent weight bearing, immobilization is important as part of the initial therapy, with a non-weight bearing cast for 6-8 weeks. </p><p>Internal fixation and even bone grafting may be required in cases of non-union, or where the fracture is significantly displaced. </p><h4>Etymology</h4><p>It was first described by <strong>Sir Robert Jones</strong> in 1902 <sup>3</sup>.</p><h4>Differential diagnosis</h4><p>A number of fractures occur at the base of the 5<sup>th</sup> metatarsal (see <a href="/articles/fractures-of-the-proximal-fifth-metatarsal">fractures of the proximal fifth metatarsal</a>) as well as entities which mimic fractures. These include:</p><ul>- +<p><strong>Jones fractures</strong> occur at the base of the fifth <a title="metatarsal" href="/articles/metatarsal">metatarsal</a>. </p><h4>Pathology</h4><p>It is a transverse fracture at the base of the fifth metatarsal, 1.5 to 3 cm distal to the proximal tuberosity at the metadiaphyseal junction, without distal extension. </p><h5>Mechanism</h5><p>The fracture is believed to occur as a result of significant adduction force to the forefoot with the ankle in plantar flexion <sup>5</sup>.</p><h4>Radiographic features</h4><h5>Plain film / CT</h5><p>A Jones fracture is located at the metadiaphyseal junction, approximately 2cm (1.5-3cm) from the tip of the 5<sup>th</sup> metatarsal, and has a predominantly horizontal course. It should not extend distally, nor should it extend to involve the articular surfaces. </p><h4>Treatment and prognosis</h4><p>In contrast to avulsion fractures, Jones fractures are prone to <a title="non-union" href="/articles/non-union">non-union</a> (with rates as high as 30-50%) and almost always take longer than two months heal <sup>2</sup>. </p><p>As displacement of the fracture can be increased with persistent weight bearing, immobilization is important as part of the initial therapy, with a non-weight bearing cast for 6-8 weeks. </p><p>Internal fixation and even bone grafting may be required in cases of non-union, or where the fracture is significantly displaced. </p><h4>Etymology</h4><p>It was first described by <strong>Sir Robert Jones</strong> in 1902 <sup>3</sup>.</p><h4>Differential diagnosis</h4><p><span style="line-height:1.6em">A number of fractures occur at the base of the 5</span><sup style="line-height:1.6em">th</sup><span style="line-height:1.6em"> metatarsal (see </span><a style="line-height: 1.6em;" href="/articles/fractures-of-the-proximal-fifth-metatarsal">fractures of the proximal fifth metatarsal</a><span style="line-height:1.6em">) as well as entities which mimic fractures. These include:</span></p><ul>
- +<li>
- +<a title="Iselin disease" href="/articles/iselin-disease">Iselin disease</a> (apophysitis)</li>
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