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Clinical Orthopaedics and Related Research

, Volume 466, Issue 8, pp 1966–1970 | Cite as

Distinguishing Jones and Proximal Diaphyseal Fractures of the Fifth Metatarsal

  • Bavornrit Chuckpaiwong
  • Robin M. QueenEmail author
  • Mark E. Easley
  • James A. Nunley
Original Article Foot

Abstract

Jones and proximal diaphyseal fractures of the fifth metatarsal are in close anatomic proximity and often are difficult to differentiate. We determined whether it is necessary to differentiate between these two diagnoses. Retrospectively, the two diagnoses were identified radiographically using an accepted classification scheme. Initial management is nonoperative; however, intramedullary screw fixation is performed for competitive athletes, or others with displaced fractures, or delayed union or nonunion. Outcomes were analyzed using Student’s t tests, whereas nominal data were analyzed using chi square tests. Thirty-two Jones fractures and 29 proximal diaphyseal fractures were identified. All fractures healed between 4.8 and 9.8 months with a 78% to 82% patient satisfaction rate. Regardless of treatment, the clinical outcomes were not different between the two fracture locations. Shorter return to sport time was observed in operatively treated patients. Operatively treated patients with fracture site sclerosis or medullary canal obliteration on radiographs had lower satisfaction and higher complication rates than patients without these changes. Based on our findings, we do not find a reason to distinguish between fractures of the fifth metatarsal in these two locations. We suggest referring to fifth metatarsal base fractures (excluding avulsions) as Jones fractures.

Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

Keywords

Nonoperative Treatment Fracture Location Displace Fracture High Satisfaction Rate Metatarsal Fracture 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

We thank the medical record department for assistance in processing the patient information.

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Copyright information

© The Association of Bone and Joint Surgeons 2008

Authors and Affiliations

  • Bavornrit Chuckpaiwong
    • 1
    • 2
  • Robin M. Queen
    • 1
    • 2
    Email author
  • Mark E. Easley
    • 1
  • James A. Nunley
    • 1
  1. 1.Division of Orthopaedic SurgeryDuke University Medical CenterDurhamUSA
  2. 2.Michael W. Krzyzewski Human Performance LabDuke University Medical CenterDurhamUSA

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