If an injury to that area has occurred, the physician is often able to interpret certain radiographic clues to make the differentiation. It is a normal finding that occurs at this site in adolescents. The X-ray appearance of the developmental "apophysis" in this area may have some resemblance of a fracture, but is not a fracture it is the secondary ossification center of the metatarsal bone. An avulsion fracture at the base of the fifth metatarsal is sometimes called a "dancer's fracture" or a "pseudo Jones fracture", and usually responds readily to non-operative treatment. If, however, it enters the tarsometatarsal joint, then it is likely an avulsion fracture caused by pull from the fibularis brevis tendon. If the fracture enters the intermetatarsal joint, it is a Jones fracture. Other proximal fifth metatarsal fractures exist, although they are not as problematic as a Jones fracture. Diagnosis includes the palpation of an intact fibularis brevis tendon, and demonstration of local tenderness distal to the tuberosity of the fifth metatarsal, and localized over the shaft of the proximal metatarsal.ĭiagnostic X-rays include anteroposterior, oblique, and lateral views and should be made with the foot in full flexion. Diagnosis Ī person with a Jones fracture may not realize that a fracture has occurred. The fracture was first described in 1902 by orthopedic surgeon Robert Jones, who sustained the injury while dancing. In athletes, or if the pieces of bone are separated, surgery may be considered sooner. Due to poor blood supply in this area, the break sometimes does not heal and surgery is required. If, after this period of time, healing has not occurred, a further six weeks of casting may be recommended. Initial treatment is typically in a cast, without any walking on it, for at least six weeks. Diagnosis is generally suspected based on symptoms and confirmed with X-rays. This movement may occur when changing direction while the heel is off the ground such in dancing, tennis, or basketball. The fracture typically occurs when the toes are pointed and the foot bends inwards. There may also be bruising and difficulty walking. It results in pain near the midportion of the foot on the outside. Pseudo-Jones fracture, normal growth plate Ī Jones fracture is a broken bone in a specific part of the fifth metatarsal of the foot between the base and middle part that is known for its high rate of delayed healing or nonunion. Pain near the midportion of the foot on the outside, bruising īending the foot inwards when the toes are pointed Fracture of the metaphysis of the fifth metatarsal Įmergency medicine, orthopedics, podiatry
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