Jones Fractures

  • K. C. Doan
  • Kenneth J. HuntEmail author


Fractures of the base of the fifth metatarsal can be a diverse and challenging problem for the treating orthopedic surgeon. As surgical fixation strategies have evolved, outcomes are better understood, and patient demands for return continue to increase, the threshold for surgical intervention has lowered. The optimal fixation strategy and decision of the most appropriate fixation construct should be tailored to the individual fracture pattern and patient factors. In general, excellent outcomes with early return to sport can be anticipated both in acute and revision scenarios. There is a trend toward a more conservative return to sport strategy following surgical repair to further reduce refracture rates. This chapter provides an overview of current treatment strategies for Jones fractures in athletes.


Jones fracture Fifth metatarsal fracture Intramedullary screw Iliac crest autograft 


  1. 1.
    Bryan D, Den Hartog M. Fx proximal fifth metatarsal. J Am Acad Orthop Surg. 2009;17:458–64.CrossRefGoogle Scholar
  2. 2.
    Petrisor BA, Ekrol I, Court-Brown C. The epidemiology of metatarsal fractures. Foot Ankle Int. 2006.Google Scholar
  3. 3.
    Wamelink KE, Marcoux JT, Walrath SM. Rare proximal diaphyseal stress fractures of the fifth metatarsal associated with metatarsus adductus. J Foot Ankle Surg. 2016;55(4):788–93.CrossRefGoogle Scholar
  4. 4.
    Thomas B, Dameron J. Proximal fifth metatarsal fractures: selecting the best treatment option. J Am Acad Orthop Surg. 1995;3(2):110–4.CrossRefGoogle Scholar
  5. 5.
    Yoho RM, Vardaxis V, Dikis J. A retrospective review of the effect of metatarsus adductus on healing time in the fifth metatarsal Jones fracture. Foot (Edinb). 2015;25(4):215–9.CrossRefGoogle Scholar
  6. 6.
    Monteban P, van den Berg J, van Hees J, Nijs S, Hoekstra H. The outcome of proximal fifth metatarsal fractures: redefining treatment strategies. Eur J Trauma Emerg Surg. 2017;44(5):727–34.CrossRefGoogle Scholar
  7. 7.
    Begly JP, Guss M, Ramme AJ, Karia R, Meislin RJ. Return to play and performance after Jones fracture in national basketball association athletes. Sports Health. 2016;8(4):342–6.CrossRefGoogle Scholar
  8. 8.
    Lareau CR, Hsu AR, Anderson RB. Return to play in national football league players after operative Jones fracture treatment. Foot Ankle Int. 2016;37(1):8–16.CrossRefGoogle Scholar
  9. 9.
    Lee TH, Lee JH, Chay SW, Jang KS, Kim HJ. Comparison of clinical and radiologic outcomes between non-operative and operative treatment in 5th metatarsal base fractures (Zone 1). Injury. 2016;47(8):1789–93.CrossRefGoogle Scholar
  10. 10.
    Porter DA. Fifth metatarsal Jones fractures in the athlete. Foot Ankle Int. 2018;39(2):250–8.CrossRefGoogle Scholar
  11. 11.
    Japjec M, Staresinic M, Starjacki M, Zgaljardic I, Stivicic J, Sebecic B. Treatment of proximal fifth metatarsal bone fractures in athletes. Injury. 2015;46(Suppl 6):S134–6.CrossRefGoogle Scholar
  12. 12.
    Hunt KJ, Anderson RB. Treatment of Jones fracture nonunions and refractures in the elite athlete: outcomes of intramedullary screw fixation with bone grafting. Am J Sports Med. 2011;39(9):1948–54.CrossRefGoogle Scholar
  13. 13.
    Duplantier NL, Mitchell RJ, Zambrano S, et al. A biomechanical comparison of fifth metatarsal Jones fracture fixation methods. Am J Sports Med. 2018;46(5):1220–7.CrossRefGoogle Scholar
  14. 14.
    Hunt KJ, Reiter MJ, Axibal DP, Varner K. Management of fifth metatarsal fracture and refracture in athletes. Oper Tech Orthop. 2018;28:61–6.CrossRefGoogle Scholar
  15. 15.
    James Jastifer M, McCullough KA. Fatigue bending strength of Jones fracture specific screw fixation. Foot Ankle Int. 2018;39(4):493–9.CrossRefGoogle Scholar
  16. 16.
    Bishop JA, Braun HJ, Hunt KJ. Operative versus nonoperative treatment of Jones fractures: a decision analysis model. Am J Orthop (Belle Mead NJ). 2016;45(3):E69–76.Google Scholar

Copyright information

© ISAKOS 2019

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryUniversity of Colorado School of MedicineAuroraUSA

Personalised recommendations