Is nonoperative treatment still indicated for Jones fracture?

Original Article
  • 100 Downloads

Abstract

Introduction:

The issue of whether to treat Jones fracture surgically or nonsurgically is still controversial. In our institution, most acute Jones fractures are treated conservatively.

Objectives:

This study assessed the functional outcomes of patients with acute Jones fractures that were treated conservatively by means of radiographic assessment, a physician-based scoring system and patient-based questionnaires.

Methodology:

In this study, 25 patients with Jones fracture treated in our institution between January 2002 to December 2006, were retrospectively reviewed. Injuries were classified according to Jones’ original description and the Torg classification. A simple patient satisfaction questionnaire was completed. Radiographic assessment of fracture union was recorded. Outcome instruments used were (a) the American Orthopaedic Foot and Ankle Society (AOFAS) clinical rating systemand (b) the American Academy of Orthopaedic Surgeons (AAOS) foot and ankle outcome questionnaire.

Results:

Of the 25 patients reviewed, 60% were very satisfied with the outcome, 28% were satisfied, 8% were fairly satisfied, and 4% were very dissatisfied. Based on radiographic and clinical assessments, one patient had delayed union and was treated surgically. The functional outcome scores were: mean AOFAS clinical rating score of 95.6 ± 7.7% (P < 0.005), mean AAOS foot and ankle score of 97.0 ± 4.4% (P < 0.005) and mean AAOS shoe comfort score of 90.2 ± 19.6% (P < 0.005).

Conclusions:

Acute Jones fracture can be treated conservatively with good functional outcome.

Key Words

Jones fracture Ankle and hindfoot Fracture healing Fractures Lower limb injuries 

References

  1. 1.
    Jones R. Fracture of the base of the fifth metatarsal bone by indirect violence. Ann Surg 1902;35:697–700.PubMedGoogle Scholar
  2. 2.
    Dameron TB. Fractures and anatomical variations of the proximal portion of the fifth metatarsal. J Bone Joint Surg Am 1975;57:788–92.PubMedGoogle Scholar
  3. 3.
    DeLee JC, Evans JP, Julian J. Stress fracture of the fifth metatarsal. Am J Sports Med 1983;11:349–53.CrossRefPubMedGoogle Scholar
  4. 4.
    Clapper MF, O’Brien TJ, Lyons PM. Fractures of the fifth metatarsal. Analysis of a fracture registry. Clin Orthop Relat Res 1995;315:238–41.PubMedGoogle Scholar
  5. 5.
    Mologne TS, Lundeen JM, Clapper MF, O’Brien TJ. Early screw fixation versus casting in the treatment of acute Jones fractures. Am J Sports Med 2005;33:970–5.CrossRefPubMedGoogle Scholar
  6. 6.
    Josefsson PO, Karlsson M, Redlund-Johnell I, Wendeberg B. Jones fracture. Surgical versus nonsurgical treatment. Clin Orthop Relat Res 1994;299:252–5.PubMedGoogle Scholar
  7. 7.
    Kavanaugh JH, Brower TD, Mann RV. The Jones fracture revisited. J Bone Joint Surg Am 1978;60:776–82.PubMedGoogle Scholar
  8. 8.
    Arangio GA. Proximal diaphyseal fractures of the fifth metatarsal (Jones’ fracture): two cases treated by cross-pinning with review of 106 cases. Foot Ankle 1983;3:293–6.PubMedGoogle Scholar
  9. 9.
    Hens J, Martens M. Surgical treatment of Jones fractures. Arch Orthop Trauma Surg 1990;109:277–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Mindrebo N, Shelbourne KD, Van Meter CD, Rettig AC. Outpatient percutaneous screw fixation of the acute Jones fracture. Am J Sports Med 1993;21:720–3.CrossRefPubMedGoogle Scholar
  11. 11.
    Portland G, Kelikian A, Kodros S. Acute surgical management of Jones’ fracture. Foot Ankle Int 2003;24:829–33.PubMedGoogle Scholar
  12. 12.
    Yue JJ, Marcus RE. The role of internal fixation in the treatment of Jones fractures in diabetics. Foot Ankle Int 1996;17:559–62.PubMedGoogle Scholar
  13. 13.
    Torg J, Balduini F, Zelko R, Pavlov H, Peff T, Das M. Fractures of the base of the fifth metatarsal distal to the tuberosity. Classification and guidelines for non-surgical and surgical management. J Bone Joint Surg Am 1984;66:209–14.PubMedGoogle Scholar
  14. 14.
    Porter DA, Duncan M, Meyer SJ. Fifth metatarsal Jones fracture fixation with a 4.5-mm cannulated stainless steel screw in the competitive and recreational athlete: a clinical and radiographic evaluation. Am J Sports Med 2005;33:726–33.CrossRefPubMedGoogle Scholar

Copyright information

© Springer 2008

Authors and Affiliations

  1. 1.Orthopaedic SurgeryInternational Medical UniversityKuala LumpurMalaysia
  2. 2.Orthopaedic SurgeryUniversity Malaya Medical CentreKuala LumpurMalaysia
  3. 3.Clinical SchoolInternational Medical UniversitySerembanMalaysia

Personalised recommendations