When Is Surgery for Jones Fractures Necessary?

The fifth metatarsal is the long foot bone connecting to the little toe. A fifth metatarsal fracture, also known as a Jones fracture, is a broken bone on the outer edge of the foot. It is one of the most usual foot injuries, and, luckily, it can be treated arthroscopically. There are actually 3 types of fifth metatarsal fractures, specifically:

  • zone 1, avulsion fracture: these fractures represent 93% of all fifth metatarsal fractures, and in one of these, a small piece of bone is pulled off the main portion of the bone by a tendon or ligament
  • zone 2, Jones fracture: they occur in a small area of the fifth metatarsal that receives less blood, and because of this, it is more difficult to heal
  • zone 3, mid-shaft fracture or dancer's fracture: these fractures typically result from trauma or twisting, and the breaks occur at the metatarsal head and neck

If the bones are in place, the orthopedic surgeon may suggest immobilization. Often, this is the only treatment needed for zone 1 fractures. Jones fractures may be treated with immobilization as a first step, too. Immobilization entails the patient stabilizing their foot in a cast or boot while the injury heals. They may also have to use crutches. Immobilization generally lasts between 6 and 8 weeks.

However, if the fracture is severe and the bones are not aligned, immobilization is no longer a viable, effective treatment option. Furthermore, if the bones are out of place more than 3 mm or if the patient is a professional athlete, their orthopedic surgeon may also recommend surgery.

Surgery for Jones fractures involves placing a pin, screw, rod, or plate into the foot to keep the bone in place. The insertion will stay in place after the bone heals, and, in some cases, the surgeon will have to remove the damaged bone around the fracture and replace it with a graft.