A Jones fracture is an extra-articular fracture at the base of the fifth metatarsal.
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.
The fracture is believed to occur as a result of significant adduction force to the forefoot with the ankle in plantar flexion 5.
Jones fracture is located at the metadiaphyseal junction, approximately 2 cm (1.5-3 cm) 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 two 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.
History and etymology
It was first described by Sir Robert Jones in 1902 3.
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:
- 1. Chuckpaiwong B, Queen RM, Easley ME et-al. Distinguishing Jones and proximal diaphyseal fractures of the fifth metatarsal. Clin. Orthop. Relat. Res. 2008;466 (8): 1966-70. doi:10.1007/s11999-008-0222-7 - Free text at pubmed - Pubmed citation
- 2. Pao DG, Keats TE, Dussault RG. Avulsion fracture of the base of the fifth metatarsal not seen on conventional radiography of the foot: the need for an additional projection. AJR Am J Roentgenol. 2000;175 (2): 549-52. AJR Am J Roentgenol (full text) - Pubmed citation
- 3. Jones R. I. Fracture of the Base of the Fifth Metatarsal Bone by Indirect Violence. Ann. Surg. 1902;35 (6): 697-700.2. - Free text at pubmed - Pubmed citation
- 4. Watson F. The Life of Sir Robert Jones. Ayer Co Pub. (1980) ISBN:0405131356. Read it at Google Books - Find it at Amazon
- 5. Theodorou DJ, Theodorou SJ, Kakitsubata Y et-al. Fractures of proximal portion of fifth metatarsal bone: anatomic and imaging evidence of a pathogenesis of avulsion of the plantar aponeurosis and the short peroneal muscle tendon. Radiology. 2003;226 (3): 857-65. doi:10.1148/radiol.2263020284 - Pubmed citation