A Jones fracture is a specific type of foot fracture that involves the fifth metatarsal. Your fifth metatarsal is the outermost bone along the outside of your foot that connects to your smallest toe (pinkie). Unlike an avulsion fracture, where a small piece of bone is pulled off the metatarsal, a Jones fracture is transverse, meaning that the break is perpendicular to the long axis of the bone. The break typically occurs between the base of the bone (near the ankle), and along the shaft of the fifth metatarsal.
What Causes a Jones Fracture?
There are primarily two reasons behind a Jones fracture. The first is from overuse, and repeated stress on the fifth metatarsal. Any type of repeated impact to this area can cause hairline fractures (stress fractures) to occur over time. Hairline fractures are microscopic cracks or damage in the bone that occur from repetitive actions like running, or jumping. The symptoms of these types of fractures are swelling, bruising, and tenderness. Eventually, these hairline fractures become too much, and your fifth metatarsal, and a Jones fracture occurs.
The second reason is sudden trauma to the area. This can happen if an individual jumps, or changes direction quickly, and ends up twisting their foot or ankle inward towards the other foot (an inversion-type sprain). What happens here is the ankle rolls towards the outside, putting immense pressure on that outside fifth metatarsal. A traumatic acute break can occur if an individual repeatedly experiences this rolling of the ankle, as over time it will weaken the bone to the point where it suddenly breaks.
Who Is Likely to Experience a Jones Fracture?
The Jones fracture is very common in athletic individuals who participate in sports that have a lot of running, or sports that place a lot of repeated pressure on the feet. Those who play football, soccer, and basketball are more likely to experience a Jones fracture. In addition to this, athletes who have high arches are at a much higher risk of experiencing a Jones fracture as more pressure is placed on the outside of their foot.
How Do You Know You Have a Jones Fracture? Symptoms.
You may believe you have nothing but an ankle sprain at first, but if resting, icing, and elevating your foot does nothing to alleviate the pain or swelling, it is critical to get looked at for a Jones fracture. Unfortunately, a Jones fracture can worsen without proper treatment due to stress, and overuse of the foot, as the fifth metatarsal is very slow to heal as it gets less blood flow. Common symptoms include:
- Bruising along the outside of the outer foot.
- Inability to bear weight, or walk on the affected foot.
- A chronic ache on the outer area of the midfoot.
- Tenderness, and swelling on the outer area of the midfoot.
- Pain on the midfoot; especially when pressure is applied.
- Tingling in the affected ankle/foot/leg.
As a Jones fracture worsens over time, you may experience a deep purple bruising, pain, numbness, and a fever. If you believe you have a Jones fracture, seek medical attention immediately. You can view what a Jones fracture looks like here.
How Is a Jones Fracture Diagnosed?
Since Jones fractures are slow to heal, and can be mistaken for other metatarsal fractures, it is critical that you seek out a medical professional for a proper diagnosis. They will walk you through the following:
- They will ask about the injury: when and where it happened?
- They will ask about the pain: when did it start?
- An examination of the foot will occur. They may choose to press on various locations around your foot to ensure that it is the metatarsal that is affected.
l They may take x-rays or use other imaging scans to confirm the diagnosis.
Because metatarsal fractures can be difficult to differentiate from, you may be referred to an orthopedic surgeon just to ensure that the diagnosis is correct, and to assess the damage to figure out what treatment path you need.
What Does Treatment Look Like for a Jones Fracture?
Jones fractures are difficult to treat because they occur in a transition area of the bone, where it goes from dense to spongy (diaphyseal-metaphyseal junction), meaning that there is less blood supply to the area. Your treatment plan may be done with a cast, or with surgery depending on your age, activity level, overall health, and the severity of the fracture. The healing time for a Jones fracture is typically 6-8 weeks, but in cases where surgery is not done, the healing time needed can extend beyond this.