Jones fractures are named after Sir Robert Jones, an orthopedic surgeon who in 1902 reported on his own injury and the injuries of several people he treated. A Jones fracture is a break between the base and shaft of the fifth metatarsal bone of your foot. This is the bone on the outside of the foot, which is connected to your smallest toe, sometimes called the pinkie toe. It’s the most common type of metatarsal fracture.
If you have a Jones fracture, you may have bruising and swelling on your foot, and it will be painful to put weight on the injured foot.
Your doctor will examine you and ask you how the injury happened. Then, they’ll take an X-ray of your foot. Many types of fractures can affect the fifth metatarsal bone. They’re difficult to differentiate, even on X-rays.
The Jones fracture is the most serious fifth metatarsal fracture. Depending on the severity of the fracture, your doctor may refer you to an orthopedic surgeon.
Your doctor can treat a Jones fracture with surgery or by immobilizing your foot. Your treatment plan will depend on:
- the severity of your break
- your age
- your overall health
- your level of activity
Surgery has a faster recovery time, so active people such as athletes may prefer it.
In a 2012 study, the bone failed to knit together in 21 percent of Jones fractures treated without surgery. In contrast, the same study found that 97 percent of Jones fractures heal well when treated with surgery and the placement of a screw in the bone.
During surgery, your surgeon will place a screw into the metatarsal bone. They’ll leave the screw in place after the bone heals, unless it becomes painful.
The screw helps the bone to bend and twist after it heals. Many variations in surgical techniques exist, but you should expect your surgeon to use X-rays to help them guide the screw into place.
Sometimes, surgeons use a bone plate to secure the screw. They may also use wires or pins. One technique involves removing the damaged bone around the fracture and replacing it with a bone graft before implanting a screw.
Your surgeon may use a bone healing stimulator, especially if the healing process is going slowly. This supplies a weak electrical current to the fracture site to encourage healing.
Conservative treatment refers to nonsurgical treatment. It involves wearing a short leg cast that immobilizes your foot. You won’t be able to put any weight on your foot, and you’ll need to use crutches while the fracture heals.
The advantage is that you won’t have the risk and discomfort of surgery. The healing process takes longer, though. You may need to wear the cast for 6 to 8 weeks.
Recovery varies depending on the severity of the break, your overall health, and the treatment method. The fracture disrupts the blood supply to the area of the Jones fracture, which may further affect healing times.
If you have surgery, you might have to wait 1 to 2 weeks before putting any weight on the injured foot. Some surgeons may allow you to put weight on your heel right away, but not on the front of your foot. In some cases, you may have to keep weight off the injured foot for as long as six weeks. After that, you may need to wear a removable walking boot.
Even after you’re allowed to put weight on the injured foot, you’ll still need to wait 3 to 4 months before returning to regular activities, including sports. One study noted that athletes who return to play too soon might experience a break along the same line as the former fracture.
With conservative treatment, you’ll have to keep your leg immobilized in a cast and avoid putting any weight on the injured foot for 2 to 5 months.
Jones fractures have a higher chance than other metatarsal fractures of not healing. They also have a higher chance of fracturing again after they’ve healed. Conservative treatment for Jones fractures has a 15 to 20 percent failure rate. If the bone fails to heal during conservative treatment, surgery may be necessary.
Reported complications include delays in bone healing, muscle atrophy, and continuing pain. Surgery can cause infection, nerve damage, or further fracturing of the bone during surgery.
If you have a high arch or tend to walk putting more weight on the outside of your foot, the stress may cause a break again in the same area. In some cases, people can have foot surgery to change the shape of the foot and reduce stress on the area.
Healing time for a Jones fracture varies depending on the treatment and the individual. Whether you have a conservative treatment or surgery, you’ll have to do the following:
- keep weight off the injured foot for a specified period
- elevate the affected leg every day for 2 to 3 weeks
- rest as much as possible
Most people can resume normal activity in 3 to 4 months. Your doctor may recommend physical therapy and exercise to help you regain functioning in the injured foot and leg.
What you can do
Follow these tips to improve your odds of a successful recovery:
- Keep weight off your foot for as long as your doctor recommends. Use crutches to get around initially. Your doctor may recommend using a walking boot later in the healing process.
- Keep your injured foot elevated as much as possible. When you’re sitting down, rest your leg on a pillow placed on another chair, footstool, or step stool.
- Use an ice pack on your foot for 20 minutes a few times per day, especially initially.
- Ask your doctor if you should take vitamin D or calcium supplements, which may help your bone heal.
- If you’re in pain, take ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn) after the first 24 hours. Ask your doctor which medication is best for you.
- Avoid smoking. Smokers have a much higher rate of failure to heal.