From the Guidelines
Surgery is the usual treatment for a Jones fracture, especially when fracture fragments are large, articular, or significantly displaced. Treatment for a Jones fracture typically involves either non-surgical or surgical approaches depending on the severity and patient factors 1. For non-displaced fractures in low-demand individuals, conservative management includes 6-8 weeks of non-weight bearing in a short leg cast or walking boot, followed by gradual return to activities using supportive footwear. However, simple immobilization is appropriate when fracture fragments are small, nonarticular, or minimally displaced 1. Pain management with acetaminophen or NSAIDs like ibuprofen (400-600mg every 6-8 hours) is recommended. For athletes, active individuals, or displaced fractures, surgical fixation with intramedullary screw placement is often preferred due to the high risk of non-union with conservative treatment. This is because Jones fractures occur in an area with poor blood supply at the base of the fifth metatarsal, making healing difficult. Post-surgery, patients typically remain non-weight bearing for 2 weeks, followed by protected weight bearing in a boot for 4-6 weeks. Some key considerations for treatment include:
- The severity of the fracture and the patient's activity level
- The risk of non-union with conservative treatment
- The importance of proper pain management and rehabilitation
- The need for careful follow-up to monitor healing and prevent complications. Given the potential for poor outcomes with non-surgical management in certain cases, a thorough evaluation of the fracture and patient factors is necessary to determine the best course of treatment 1.
From the Research
Treatment Options for Jones Fracture
The treatment for a Jones fracture can vary depending on the severity of the injury and the patient's overall health. Some of the treatment options include:
- Conservative management with a non-weight-bearing cast or a walking boot
- Surgical intervention using intramedullary screw fixation or plate fixation
- Nonsurgical management with weight-bearing restrictions
- Biologic augmentation and primary bone grafting for complex cases
Conservative Management
Conservative management of Jones fractures can be effective, especially for patients who are risk-averse and prefer to avoid surgery 2, 3. A study published in 2022 found that conservative management with immediate weight-bearing in a walking boot demonstrated healing in patients with acute Jones fractures 3. Another study published in 1994 reported good results in 40 cases of Jones fractures treated with closed treatment after 11-26 years 4.
Surgical Intervention
Surgical intervention is sometimes necessary for Jones fractures, especially for patients with displaced fractures or those who have failed conservative management 2, 5. A study published in 2013 discussed the technical considerations for surgical intervention of Jones fractures, including percutaneous intramedullary screw fixation 5. Another study published in 2022 reviewed the diagnosis and treatment considerations for Jones fractures, including surgical options such as intramedullary screw fixation and plate fixation 6.
Rehabilitation and Outcome
The rehabilitation protocol and outcome for Jones fractures can vary depending on the treatment approach. A study published in 2022 found that patients who underwent conservative management with a walking boot had similar outcomes to those who underwent cast immobilization with weight-bearing restrictions 3. Another study published in 2024 found that surgical treatment was sometimes necessary for Jones fractures, but conservative treatment should also be considered due to favorable outcomes 2.