![]() Am J Sports Med 11:349–353įernández Fairen M, Guillen J, Busto JM et al (1999) Fractures of the fifth metatarsal in basketball players. J Bone Joint Surg Am 57:788–792ĭelee JC, Evans JP, Julian J (1983) Stress fracture of the fifth metatarsal. Accessed ĭameron TB (1975) Fractures and anatomical variations of the proximal portion of the fifth metatarsal. Foot Ankle Int 32:746–754Ĭritical Appraisal Skills Programme. Level of evidenceĪlvarez RG, Cincere B, Channappa C et al (2011) Extracorporeal shock wave treatment of non-or delayed union of proximal metatarsal fractures. Early return to play in athletes prior to full radiological union is not advised in case of re-fracture. ConclusionsĪlthough supported by mostly level 4 evidence, intra-medullary screw fixation is more likely to lead to successful union of all types of Jones fractures compared to non-operative treatments. Non-unions treated with screw fixation healed in 97 % of cases. Delayed unions treated non-operatively had a union rate of 44 and 97 % treated operatively. Acute fractures treated non-operatively had a union rate of 76 % (pooled), whereas in fractures treated with a screw it was 96 % (pooled). Return to sports following intra-medullary screw fixation for acute fractures ranged from 4 to 18 weeks. Functional outcome data were limited to return to sports in most studies with few studies using established scoring systems. Twenty-six studies were included, of which 22 were level 4 evidence, with only 1 randomised controlled trial. Jones fractures were segregated into acute fractures, delayed unions and non-unions. Studies were included based on set criteria and analysed for their validity, and their results were scrutinised. MethodsĪ thorough literature search was performed from 1980 to present day. By doing this, the clinician will be better prepared to institute a logical, evidence-based approach to the treatment of their patients with this injury. The study aimed to establish what the outcomes were for different treatments modalities. After your fracture has healed and the cast has been removed, we can work with you and you physician to design a program to safely restore strength and flexibility to your ankle.The aim of this study is to better inform the sports surgeon of current evidence for the treatment of Jones fractures of the base of the 5th metatarsal. Physical therapy is always needed after the stress fracture has healed.Ī fracture of the fifth metatarsal is a common and disabling injury. During the healing period, he patient may maintain fitness by cycling, aqua-running or resistance training on equipment that does not involve the affected area. They may be treated like a Jones fracture with a non-weight-bearing cast for up to 20 weeks, or they may require surgery. Low-grade pain and swelling are often present for weeks before a diagnosis is made. A stress fracture develops over time from the repeated application of force (produced by jumping or running, for instance), overuse or weakening of bone caused by osteoporosis.We can help you learn to use crutches during the non-weight-bearing phase. Jones fractures are treated with a non-weight-bearing cast for six to eight weeks, followed by physical therapy. Symptoms are similar to an avulsion fracture. Jones fractures often occur when the toe is pointed down, the heel is off the ground and pressure is applied to the outside of the ankle. A Jones fracture is a sudden fracture three-quarters of an inch (1 cm) beyond (proximal to) the metatarsal.Healing usually takes six to eight weeks. Avulsion fractures are treated with immobilization and stiff boots or a weight-bearing cast. They cause pain, swelling and bruising along the outside edge of the foot, especially in the area where the bone bumps out. Avulsion fractures usually occur when the ankle rolls inward. In an avulsion fracture, a chip of bone is pulled off when the tendon attached to the metatarsal is overstressed.There are three main types of fifth metatarsal fractures: avulsion fracture, Jones fracture and stress fracture. They can be difficult to heal because the blood supply is poor in the region where the fractures occur. Fractures of the fifth metatarsal are common in dancers and in sports where athletes pivot forcefully. This bump and the area just in front of it are prone to injury. Run your hand along the outside of your foot, and you will feel a bump or tuberosity on the fifth metatarsal. The fifth metatarsal is a bone that extends from the cuboid bone near the ankle to the base of the little toe.
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