Brian Conroy, M.D., Orthopaedic surgeon with the
Alegent Health Orthopaedic Institute.
Find out more about Dr. Conroy
Q:
I am doing a project for my sports medicine
class on a Jones Fracture, and I was wondering if you could give me some information about it such as the type of surgery used and a definition.
Sir Robert Jones was one of the first surgeons to concentrate on the
musculoskeletal system. The description of this fracture dates back to around
1902. Dr Jones injured his foot (dancing I believe)and found that the type of
fracture he had experienced was unique and he collected cases of other patients
with similar fractures. The fracture he described was a transverse fracture at
the base of the fifth metatarsal specifically at the junction of the metaphysis
and diaphysis without extension distal to the proximal 4th/5th intermetatarsal
joint.
The figure below gives a description of the Jones
fracture region and also shows two other similar but distinct fractures at the
base of the 5th metatarsal.
Surgery for a Jones
fracture is probably best suited for individuals with displaced fracture
(meaning the ends are far apart and not lined up well), and occasionally for
those people, such as some professional athletes, who cannot afford to be off
their feet. Inadequate healing after several months of limited weight bearing
may also be an indication for surgery.
The most common form of surgical treatment for fractures at the base of the 5th metatarsal is an intramedullary screw. This means a screw is placed across the fracture site starting from the base of the 5th metatarsal, through the fractured region, then the tip of the screw enters into the canal of the 5th metatarsal beyond the fracture. This compresses the fracture site to facilitate healing by stabilizing the fracture and reducing the fracture gap between the bone ends.
Other forms of fixation may include wiring or the addition of a plate.
Occasionally, bone grafting is performed by taking bone from another region of
the body and laying the bone next to the fracture to create a better environment
for healing. The limitation to healing in this region is typically a reduced
blood supply.
