A Jones Fracture is a fairly common fracture which occurs at the base of the fifth metatarsal bone of the foot. This is the bone attached to the pinky toe. This condition has been in the news recently due to a Jones Fracture suffered by NBA star Kevin Durant, which is expected to keep him out of action for an extended period of time.
There are a couple of issues which can make this condition more problematic than expected. One is that it is often misdiagnosed and treated improperly, if it all. The other is that the supply of blood to this area of the foot is very small. This means that the healing process can be very slow even under normal conditions. If treated improperly, the blood supply can be practically cut off from the area. This can obviously impede the healing process dramatically, and can result in making surgery necessary.
Jones Fractures often occur when the foot or ankle twists inward, resulting in abnormal stress to the fifth metatarsal. This is not an uncommon occurrence for athletes and dancers. In particular, dancers can cause repetitive stress on the area when doing certain moves, and this overuse is a prevalent cause of Jones Fractures. The condition is actually sometimes referred to as Dancer’s Fracture because it is quite common for those individuals. Basketball players can often land awkwardly on the foot and stress the area as well.
The reason that the condition is often diagnosed improperly is that the symptoms are quite similar to sprains or avulsion fractures. Avulsion fractures occur when a bone fragment tears away from the main bone mass due to trauma to the area. This foot trauma can sometimes result in Jones Fractures as well. The symptoms for all of these conditions can be similar. These include bruising, swelling, and moderate to severe pain when walking. An x-ray is the only way to accurately diagnose that a Jones Fracture has occurred.
The severity of the Jones Fracture will usually determine the direction of the ensuing treatment. Less severe fractures are usually treated with a cast, splint or walking boot. This will be required for a six to eight week duration, a portion of which may require no weight bearing. Rest is mandatory to ensure proper healing has a chance to occur. From a nutrition standpoint, increasing the amount of vitamin D and calcium intake can be a healing benefit. This treatment is usually successful for 75 percent of less severe cases. NSAID’s (non-steroidal anti-inflammatory drugs) are often prescribed during this healing period to reduce inflammation. Following this phase of treatment, there will usually be a two to three week period of rehabilitation as well.
For more severe fractures, surgery is usually the only answer. This will likely be the next step in the event of improper healing for milder fractures as well. Chronic cases, even if not a severe fracture, will usually result in surgery to finally correct the problem. A choice of several hardware devices can be implemented during surgery to ensure the fracture is stabilized. These includes pins, plates, screws, and wires. A bone stimulator can also be utilized to stimulate healing of the bone. This can be accomplished in several ways, and is beyond the scope of this post.
After the surgery, the foot is normally put in a cast for protection of the bone. Usually no weight should be put on the foot for up to two weeks after surgery, but this can sometimes be lengthened to as long as six weeks. A walking boot is often the next phase of the recovery. The normal recovery time to full activity after surgery is 3 to 4 months. The stabilization hardware installed during surgery is usually left in the foot unless it causes some discomfort.
For athletes, surgery is often recommended regardless of the severity of the fracture. This is due to the excessive stresses that they put on the foot. It is not unusual for these fractures to become chronic for athletes, so it is best to be cautious in allowing them to return to full activity. The majority of people are able to recover fully from Jones Fractures and return to all activities.
Image courtesy of flickr/Mills Baker