The role of non-operative management in the treatment of the Jones fracture: a six-year series

A.C. Keenan, A.M. Wood, R.M. Boyle, F.C. Doogan, C. Court-Brown

Introduction: The orthopaedic literature appears to highlight the Jones fracture of the fifth metatarsal, as being slow to heal, and having a high incidence of non-union. The authors present the largest case series currently published of 117 patients who sustained a Jones fracture, demonstrating patient outcomes with conservative treatment.

Methods: A computer program was use to search the Emergency department database of the Edinburgh Royal infirmary notes data base for terms 5th metatarsal combined with a coding for referral to fracture clinic over a 6 years period from 2004-2010. The researchers went through the X-ray archive, identified and classified all 5th metatarsal fractures.

Results: There were 117 patients in our series, Average time to discharge 13 weeks (4-24). 19% of patients took longer than 18 weeks for their fracture to clinically heal. At six weeks 34% were clinically healed, 59% at 12 weeks and 81% at 18 weeks. A refracture rate 6/117 5.1% was seen. A similar number of patients were managed in cast (44/ 38%) and Moonboot (50/ 43%). Those treated with a Moonboot heal significantly faster that those treated in cast (p=0.0027).

Conclusion: A large proportion of Jones fractures have delayed healing, patients who are clinically asymptomatic may not have radiological healing.