Jones fracture
A Jones fracture is a transverse fracture through the proximal fifth metatarsal bone, whereas a pseudo-Jones fracture is through the base of the same bone.

The metatarsals are the long bones of the foot. The fifth metatarsal base fractures are among the most common fractures of the foot. These fractures are prone to slow healing because of the restricted blood supply to the areas of the fifth metatarsal base.

  • A Jones fracture is a transverse fracture that runs through the proximal fifth metatarsal bone in the metaphyseal-diaphyseal junction, excluding the articular surface.
  • When a small fracture line transverses the base of the fifth metatarsal bone, including the articular surface, consistent with an avulsion fracture, it is called a pseudo-Jones fracture.

What causes metatarsal fracture?

A direct hard impact to the bone is generally the reason for a fracture of the fifth metatarsal. This might happen if you drop something heavy on your foot or land on your foot or ankle wrong. Twisting exercises can likewise fracture the bone.

Putting an excess of weight on the bone or too much movement in a short duration of time can cause a fracture of the fifth metatarsal. This is called “stress fracture.” Individuals who do proactive tasks, such as dancing or running, are more inclined to stress fractures.

What are the signs and symptoms of Jones and pseudo-Jones fracture?

Jones and pseudo-Jones fractures have similar symptoms.

  • Unexpected pain along the outside of your foot is the primary indication.
  • You might feel constant pain for a period along the affected foot.
  • Your foot may swell and bruise, and you might have trouble walking and carrying on with your daily activities.
  • Discoloration and tenderness to touch are other symptoms of a metatarsal fracture.

A stress fracture might develop symptoms more gradually.

In case that you experience any of the symptoms, it is best to look for clinical treatment. If you think you have broken a bone in your foot, you should stop activities and talk to your doctor.

How is the diagnosis made?

An individual with such fractures may not know that they have a fracture and may mistake it for a sprain.

Diagnosis is made by the orthopedic doctor by palpation of an intact peroneus brevis tendon that lies behind the bone called the fibula. The confirmation of tenderness near the fifth metatarsal that is confined over the shaft of the proximal metatarsal may be the clue.

Diagnostic X-rays often help make the diagnosis. In some cases, a computed tomography scan may be required for better visualization.

How are Jones and pseudo-Jones fractures treated?

Treatment will depend on several factors, including:

  • Activity level
  • The severity of the fracture
  • The overall health of the person

The initial step of treatment is to get rest and avoid movement of the foot. Apply ice to the break too and keep the injured foot above the level of the heart. These simple steps may help prevent the fracture from worsening while waiting for treatment.

The first step of treatment is usually putting a cast, with no weight being put on it, for no less than six weeks. If the foot has not healed after this timeframe, a further six weeks of casting may be recommended.

After the cast is removed, you need to have rehabilitation. This includes stretching and strengthening exercises to get back to previous activity levels slowly but securely.

If in case the pieces of bone are separated by more than 2 mm, surgery might be considered to fix the fracture with a metal screw.

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Medically Reviewed on 11/24/2021
References
Image Source: iStock Images

MSD Manuals. Jones vs Pseudo-Jones Fractures. https://www.msdmanuals.com/en-in/professional/multimedia/image/v13386028

Silbergleit R. Foot Fracture. Medscape. https://emedicine.medscape.com/article/825060-overview