Jones Fractures

A fifth metatarsal fracture, commonly caused by injury or overuse, results in pain and swelling on the outside of the foot, with treatment options ranging from rest to surgery depending on the severity of the break.

What Is a Fifth Metatarsal Fracture?

Fifth metatarsal fractures (breaks) are common foot foot injuries. The fifth metatarsal is the long bone on the outside of the foot that connects to the little toe.

Two types of fractures that often occur in the fifth metatarsal are:

  • Avulsion fracture. In an avulsion fracture, a small piece of bone is pulled off the main portion of the bone by a tendon or ligament. This type of fracture is the result of an injury in which the ankle rolls. Avulsion fractures are often overlooked when they occur with an ankle sprain.
     
  • Jones fracture. Jones fractures occur in a small area of the fifth metatarsal that receives less blood and is therefore more prone to difficulties in healing. A Jones fracture can be either a stress fracture (a tiny hairline break that occurs over time) or an acute (sudden) break. Jones fractures are caused by overuse, repetitive stress or trauma. They are less common and more difficult to treat than avulsion fractures. Other types of fractures can occur in the fifth metatarsal. Examples include midshaft fractures, which usually result from trauma or twisting, and fractures of the metatarsal head and neck.

Symptoms

Avulsion and Jones fractures have the same signs and symptoms. These include:

  • Pain, swelling and tenderness on the outside of the foot
  • Difficulty walking
  • Bruising

Diagnosis of a Fifth Metatarsal Fracture

To arrive at a diagnosis, Dr. Levick will ask how the injury occurred or when the pain started. The foot will be examined, with the doctor gently pressing on different areas of the foot to determine where there is pain. She will also order x-rays. Because a Jones fracture sometimes does not show up on initial x-rays, additional imaging studies may be needed.

When Is Surgery Needed?

If the injury involves a displaced bone, multiple breaks or has failed to adequately heal, surgery may be required. Dr. Levick will determine the type of procedure that is best suited to the individual patient.

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