Humans are able to walk here and there with help of the lower limb that comprises feet and legs. The ability of a person to walk freely without feeling any pain or discomfort certainly a blessing in disguise. There are a number of disorders or diseases affecting the feet which may lead to a person unable to walk properly. Among the many of these diseases or disorders, one of the common ones is Jones fracture. In this DoctorOnCall’s article, we will know more about this specific fracture.
To better understand Jones fracture, it would be best to know about 5th metatarsal fracture first. 5th metatarsal fracture is one of the common foot injuries. The 5th metatarsal is the long bone outside of the foot that connects to the little toes. Each foot consists of 5 metatarsal bones. 5th metatarsal fractures are common in athletes and military recruits. Direct trauma is common in industrial workers who have had heavy objects fall on their feet. Indirect trauma such as in athletes is caused when the leg and hindfoot are twisted while the forefoot is fixed. Metatarsal fractures are common in children as it makes up 60% of the case of foot fractures in children and the 5th metatarsal fracture is the most common one.
There are two types of fracture that is usually associated with the fifth metatarsal fracture. The first one is an avulsion fracture. In avulsion fracture, a small piece of bone is pulled off from the main portion of the bone by a tendon or ligament. This is usually due to an injury from ankle rolls leading to strong traction force by tendon and ligaments attached to it. The second is Jones fracture. Jones fractures occur in the small area within the fifth metatarsal near the end of the bones that is closest to the ankle. This area is where the fifth metatarsal receives less blood. Jones fracture is usually caused by overuse, repetitive stress or trauma. Another type of fracture of the 5th metatarsal fracture is pseudo-Jones fractures. It is usually caused by crush injury or a strong inward force causing the tendon to be pulled away. Other type of fractures include midshaft fractures and fractures of the metatarsal head and neck. The most common type of 5th metatarsal fracture is the avulsion fracture.
Symptoms of 5th metatarsal fracture are the same despite there being 2 different types. Common symptoms for Jones fracture include signs of inflammation such as swelling and tenderness on the outside of the foot, painful sensation, bruising and difficulty walking. Pain often gets worse when a person tries to walk. Pain may occur weeks or months after trauma or repetitive microtrauma such as from sports.
Speaking of fracture, you might already imagine the pain or the difficulty of moving limbs or walking. You may even wonder if you can walk with Jones fracture. Yes, many people can walk despite having a Jones fracture. However, you will find that there is mild pain or discomfort. You may also feel like the toes are moved when you wiggle but not see any movement.
When a patient comes to a doctor presenting with foot pain or walking difficulties, doctors will first ask how injury occurred and how the pain started. Foot examination will be done and during this examination, patients might feel slight discomfort as doctors are trying to locate the pain and its possible source by touching, putting pressure or manipulating the foot. Doctors usually order imaging tests such as X-ray to get a detailed look of the feet structures. At times, doctors may order for additional imaging tests such as CT or MRI scans since some cases such as Jones fracture may not be visible from x-ray alone.
Treatments depend on the location of the fracture. Common treatment includes immobilisation and bone stimulation. Immobilisation is done with a cast, walking, boot or hard-soled shoes. Crutches can help minimise weight placed on the injured foot. Bone stimulation is usually used to treat Jones fracture since Jones fracture is difficult to heal due to the low blood supply. Bone stimulation is a device that generates electric current to encourage bone growth and to reduce pain. In severe cases, surgery such as screw fixations may be recommended. Surgery is usually recommended if a bone is displaced, presence of multiple bone breaks or when the fractures fail to heal with nonsurgical treatment.
In essence, Jones fracture, being the 5th metatarsal fracture, is one of the most common foot injuries. It could occur to anyone. It is important to get immediate medical care when a person is highly suspicious for foot fracture. Treatment can be as simple as rest to complex surgery, depending on the location of the fracture and its severity. It is best to get checked by a doctor whenever there are symptoms of fracture despite being mild.