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The Jones fracture revisited

J H Kavanaugh, T D Brower, R V Mann

    The Journal of Bone and Joint Surgery. American Volume
    |September 1, 1978
    PubMed
    Summary

    Jones fractures, or proximal fifth metatarsal diaphysis fractures, often affect athletes. Conservative treatment leads to high rates of delayed union, suggesting surgical fixation may be beneficial.

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    Area of Science:

    • Orthopedic Surgery
    • Sports Medicine
    • Biomechanics

    Background:

    • The proximal diaphysis of the fifth metatarsal is susceptible to fractures, commonly known as Jones fractures.
    • These injuries can cause significant disability, particularly in athletes.
    • Conservative management has shown high rates of delayed union.

    Purpose of the Study:

    • To report on a series of proximal fifth metatarsal diaphysis fractures.
    • To investigate the mechanism of injury.
    • To evaluate treatment outcomes and provide recommendations.

    Main Methods:

    • Retrospective review of twenty-two patients with twenty-three fractures.
    • Average follow-up of 3.5 years.
    • Force-platform analysis in eleven cases to assess injury mechanism.

    Main Results:

    • Twelve of eighteen conservatively treated patients (66.7%) experienced delayed union.
    • Four patients underwent early surgical intervention.
    • Force-platform analysis indicated vertical and mediolateral forces, not inversion, cause the fracture.
    • Young athletes comprised a significant portion of the injured population.

    Conclusions:

    • Conservative treatment for proximal fifth metatarsal diaphysis fractures has a high incidence of delayed union.
    • Intramedullary screw fixation is recommended for young athletes, recreational athletes, and non-athletes with delayed union.
    • Understanding the biomechanical forces is crucial for injury prevention and management.

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