Overview of Jones Fractures on the Foot

Fractures are most common among athletes who run and jump but they can occur in anyone. A Jones fracture is a broken pinky toe. Fortunately, there are treatments, both non-surgical and surgical, to help these fractures heal.

What is a Jones Fracture?

A Jones fracture is a break in the fifth metatarsal bone, the fifth toe on the foot. One feature that distinguishes it from other common bone fractures of the foot is it’s a transverse fracture. This means the break is perpendicular to the long angle of the bone. Jones fractures are one of the most common foot fractures. In some cases, they are hard to detect on a routine x-ray and may need more advanced imaging.

Symptoms of a Jones Fracture

Jones fractures are characterized by tenderness at the site of the fracture and pain when you step or press on the side of the foot. Walking or bearing weight on the foot may be difficult if the fracture is severe, and there may also be bruising around the site. The symptoms may come on slowly if the fracture is caused by a repetitive use injury, or sudden if the break happens quickly.

How Does a Jones Fracture Occur?

A Jones fracture may occur from an acute injury, such as when the ankle rolls laterally while running or jumping, or when the ankle twists. These movements on a hard or uneven surface increases the risk. Repeated stress to the feet, such as long-distance running or jumping, can also cause the fracture over time. Jones fractures can also develop with other injuries of the feet, which the doctor must also diagnose and treat.

Diagnosis of Jones Fractures

A doctor will do a physical exam first. The exam may show swelling and tenderness at the base of the pinky toe. An x-ray is usually the next diagnostic step, but a Jones fracture may not show up on an x-ray and may require an MRI to visualize. Using information from x-ray and imaging studies, doctors divide Jones fractures into one of three types (Type 1, 2, or 3) based on the severity. They also divide them into one of three zones based on where the fracture occurs on the fifth metatarsal. The type and zone affect the prognosis and treatment.

Treatment of a Jones Fracture

The treatment of a Jones fracture will depend on how severe the fracture is (type 1, 2, or 3), the age of the person, and how active they are. The first line of treatment is to rest the foot and avoid bearing weight. In some cases, it may be necessary to immobilize the foot in a boot or cast to reduce stress on the area. This will necessitate using crutches. Applying ice helps reduce the pain and swelling. If the fracture doesn’t heal after 6-8 weeks, surgery may be necessary. The most common surgical approach is opening the bone and placing a screw inside to fix the fracture. After surgery, most people will need to wear a walking boot for 6 to 8 weeks.

How Long Does Recovery from a Jones Fracture Take?

If conservative therapy works, a Jones fracture will usually heal in 6 to 8 weeks. Unfortunately, this type of fracture has a high rate of nonunion, which is when the bone doesn’t form a healthy reconnection. In those cases, the patient may need surgery. After surgery, it’s important to reduce stress on the foot by wearing a protective walking boot for at least 6 weeks.

Possible Complications of a Jones Fracture

Once a Jones fracture occurs, there’s a high rate of refracture, so it’s important to take steps to lower the risk. Another complication can be a failure to heal — requiring surgery — and persistent pain even after healing. If the fracture requires surgery, possible complications include infection, blood clots, bleeding, nerve damage, or reactions to the anesthesia. Plus, the surgery may not be successful.

Alternative Therapies for Jones Fractures

There are no science-backed alternative treatments for a Jones fracture. The conventional approach of not bearing weight, wearing a boot or cast, and, in some cases, surgery, is the established treatment course. However, alternative therapies such as meditation or deep breathing exercises may help with pain management and stress relief.

Getting Back to Normal Activities

Once the fracture has healed, weight-bearing should be gradual. Some doctors recommend a structured rehabilitation program to safely return to exercise. The first step will usually be walking, followed gradually by higher impact exercise once strength is regained and there’s no pain when running or jumping. Advancing training too fast increases the risk of refracturing the area.

Preventing Jones Fractures

The key to preventing Jones fractures is to avoid repetitive stress on the feet by not overtraining and using the appropriate form when running or jumping. Wear supportive shoes that protect your feet when you train and don’t train on hard or uneven surfaces.