Jones Fracture

MANUAL MINORS

A Jones fracture is a fracture at the base of the 5th metatarsal, specifically at the junction between the diaphysis and metaphysis, approximately 1.5-3 cm from the tip of the bone. This is a serious injury due to limited blood supply in this area, resulting in slow healing and a high risk of non-union. It commonly occurs due to twisting or repetitive stress, particularly in athletes and individuals involved in sports.

Diagnosis

Diagnosis is based on a history of acute lateral foot pain, usually following a twisting movement or jump. X-rays of the foot in anteroposterior, lateral, and oblique projections are essential to identify the fracture in the metaphyseal-diaphyseal region of the 5th metatarsal. MRI or CT scans can be helpful in difficult-to-assess cases.

Differential Diagnosis

Condition	Key Difference
Avulsion fracture of the 5th metatarsal	Occurs at the proximal base of the bone near the insertion of the peroneus brevis tendon.
Stress fracture of the 5th metatarsal	Gradually develops in athletes, without acute trauma.
Ankle sprain	More generalised pain around the ankle, with no bony findings on X-ray.

Emergency Management

In the emergency setting, initial treatment includes immobilisation of the foot with a splint or orthopaedic boot. Weight-bearing should be avoided, and crutches are recommended. Pain management involves analgesics and NSAIDs. Additional imaging may be required if a hidden or displaced fracture is suspected.

Definitive Treatment

Conservative treatment involves immobilisation and non-weight-bearing for 6-8 weeks. However, due to the high risk of non-union, surgical treatment is often recommended. This typically involves the insertion of an intramedullary screw or compression plates to ensure proper bone healing. Post-surgical recovery includes rehabilitation to restore foot function and strength.