Jones Fracture of the Foot: Symptoms, Treatment, and Recovery

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A Jones fracture of the foot is a break in the long bone that connects the pinky toe (fifth metatarsal) to the base of the foot. Bruising and swelling are common symptoms, and you may have difficulty bearing weight or walking on that foot.

Jones fractures are caused by sudden force on the outside of the foot which can occur with repetitive overuse, playing sports, dancing, or a slip-and-fall accident. Treatment may include casting or wearing a non-weight-bearing boot. In some cases, surgery may be required.

This article explains a Jones fracture of the foot, its causes, and symptoms. It also discusses how Jones fractures are diagnosed and treated.

x-ray image of bone fracture at 5th Metatarsal left foot
ChooChin / Getty Images

Jones Fracture Symptoms

Typical symptoms of a Jones fracture may include:

  • Pain over the middle section of the fifth metatarsal of the foot
  • Swelling
  • Bruising or discoloration
  • Stiffness
  • Tenderness
  • Difficulty walking

When the fracture isn't caused by a traumatic event, the pain may develop gradually over several weeks or even months until it becomes bothersome enough to require medical attention. Swelling and discoloration may not be present in these cases.

What Causes a Jones Fracture?

Jones fractures may be caused by a specific traumatic event or a chronic overuse situation.

When they occur traumatically, such as while playing sports, it's usually the result of an inversion-type sprain (the foot is turned inward towards the other foot). This is the same type of injury that can cause an ankle fracture.

When Jones fractures result from repetitive overuse injuries, such as walking or running on hard surfaces for long periods, the bone may slowly crack or weaken to a point where a traumatic acute break can occur.

What Are Risk Factors?

Risk factors for a Jones fracture include:

  • Participating in activities where you may experience sudden injuries, such as sports involving jumping or twisting quickly
  • Engaging in activities that involve long-term, low-grade stress on the outside parts of your feet
  • Playing sports that involve a lot of pivoting movement, like basketball or soccer
  • General foot posture and having high arched feet

Prevention

For individuals who have an increased risk of getting a Jones fracture, there are a few ways to help prevent this injury, such as:

  • Having an awareness of your increased risk may help you be more mindful of your general posture and movement
  • Wearing corrective orthotics—medical devices worn inside your shoes that help with foot concerns
  • Wearing braces that protect the front and outer part of your feet

Diagnosing a Jones Foot Fracture

To diagnose a Jones fracture, your healthcare provider:

  • Will ask you questions about your pain and the injury in general
  • Will examine your foot visually and may press on certain parts of it
  • May order imaging like an X-ray, which is also called radiography
  • May order other imaging studies like magnetic resonance imaging (MRI) and computed tomography (CT) scans to monitor the injury and how it's healing

Jones Fracture vs. Avulsion Fracture

Jones fractures occur in the middle section of the fifth metatarsal, whereas avulsion fractures occur at the base of the fifth metatarsal.

Jones Fracture Treatment

A Jones fracture is located near the middle of the bone, an area that can be difficult to heal because it lacks blood supply. Treatment of Jones fractures may involve casting and/or surgery.

The treatment plan often depends on the person's age, activity level, overall medical health, and type of Jones fracture. Either way, bone healing takes around eight weeks.

Sometimes people can still walk with a Jones fracture, but it may be difficult or painful to do so. Follow your healthcare provider's instructions on how to walk safely while allowing your fracture to heal.

Will a Jones Fracture Heal Without Surgery?

In some cases, a Jones fracture can heal without surgery. Your healthcare provider may immobilize your foot with a cast or boot.

Studies suggest that non-surgical treatment methods work successfully between 77% and 93% of the time depending on the exact fracture location.

  • Individuals who are treated without surgery are generally immobilized with a solid cast that starts below the knee and extends to the toes for a period of six to eight weeks.
  • Others may be able to use non-weight-bearing medical boots.

Healthcare providers usually advise crutches until bone healing is seen on the X-ray or other imaging technique. Jones fractures are notorious for delayed healing, and immobilization can extend to three or more months in some cases.

If the bone doesn't heal within six weeks, surgery may be necessary.

Jones Fracture Surgery

In many cases, surgery is needed to heal a Jones fracture.

Surgery methods tend to heal Jones fractures faster than non-surgical methods. Studies suggest that surgery methods work successfully nearly 96% of the time.

  • The most common method for surgery involves placing a single surgical bone screw to hold the bone fragments together. This screw starts at the tip of the bone and is inserted into the inner canal of the metatarsal bone.
  • Plantar plate fixation may also be used. This involves surgically placing a plate that contours over the injury. This is one of the fastest ways to heal a Jones fracture.

Research suggests that surgery may reduce healing time by 50%, which may be especially important for athletes.

Complications

Although Jones fractures heal slowly, they are not usually considered a serious injury. However, there are some potential complications of a Jones fracture including:

  • Surgery-related risks such as infection, nerve and blood vessel damage, and bleeding
  • Risks associated with anesthesia, the medicine used to make you unconscious and reduce pain during surgery
  • Risk of re-injury, which occurs more often with non-surgical treatment methods
  • Screw or plate failure that may irritate the soft tissues of the foot
  • Long-term pain

Outlook

The majority of individuals have good outcomes whether treated surgically or non-surgically. Most individuals can return gradually to normal activity within about six weeks. However, for some, this may take several months.

Jones Fracture Recovery

Healing time for a Jones fracture can take about eight weeks with or without surgery, and you may need physical therapy after your foot has healed.

The challenge with Jones fractures is that the fracture occurs within a segment of bone that is considered less vascular, which ultimately means prolonged healing times.

Surgery, by placing the screw, is thought to help the bone heal in approximately six weeks. Additionally, some surgeons allow for protected walking after surgery for Jones fractures. When treated without surgery, the bone healing may extend beyond six weeks and may take three months or more.

Some healthcare providers recommend bone healing devices, called bone stimulators, for these fractures to try to shorten healing time.

Jones fracture recovery tips to keep in mind:

  • Follow medication instructions if your healthcare provider has prescribed you painkillers.
  • Use your crutches as instructed and follow instructions regarding cast care.
  • See a physical therapist if your healthcare provider has suggested that you do so, as they can give you helpful exercises to rebuild your strength.

Summary

A Jones fracture of the foot is a break in the fifth metatarsal bone. Symptoms may include bruising, swelling, pain, and difficulty or inability to walk. Treatment may include immobilizing the foot with a cast or medical boot or surgery to repair the break. Recovery can take a couple of months and may require physical therapy.

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By Neal Blitz, DPM, FACFAS
 Neal Blitz, DPM, FACFAS, is a board-certified doctor of podiatric medicine and creator of the Bunionplasty procedure.