Jones Fracture - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describes the condition of Jones fracture - 5th metatarsal base.
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Jones Fracture
Sir Robert Jones (British Surgeon) sustained an acute fracture at the base of the fifth metatarsal bone while dancing, and the fracture was then named after him. The Jones fracture occurs at the metaphyseal/diaphyseal junction, and it extends into the intermetatarsal joint proximal to the metatarsocuboid joint. One joint articulates with the cuboid bone (metatarsocuboid) and the second joint (intermetatarsal) articulates with the 4th metatarsal. For the Jones fracture to be called “Jones Fracture”, the fracture must enter the intermetatarsal joint (fracture must be distal to the metatarsocuboid joint and must enter the intermetatarsal joint). The Jones fracture occurs about 1 ½ cm distal to the tuberosity of the 5th metatarsal bone. The 5th metatarsal bone is divided into the head and shaft. Jones fractures of the proximal fifth metatarsal occurs in the watershed area within 1.5cm of the tuberosity. The area where the Jones fracture occurs is an area of limited blood supply. There are multiple metaphyseal arteries in the tuberosity. Nutrient artery with intramedullary branches provides retrograde blood flow to the proximal fifth metatarsal. Fracture distal to the tuberosity will disrupt the nutrient artery supply resulting in relative avascularity. The Peroneus Tertius tendon is inserted into the dorsal metaphysis of the 5th metatarsal bone. The Peroneus Brevis tendon is inserted into the tuberosity of the 5th metatarsal bone. The plantar fascia is connected to the fifth metatarsal bone. When a Jones fracture occurs, the tendons will pull the fracture apart and prevent healing. This fracture could be mistaken for a sprain because a sprain is common on this side of the foot. There are three types of fractures at the proximal fifth metatarsal: Zone I, Zone II, and Zone III. Zone I fractures are avulsion fractures (pseudo Jones Fracture) and occur at the Peroneus Brevis insertion site; they require conservative treatment. Zone II fractures are acute fractures that occur at the metaphyseal-diaphyseal junction and involve the 4th and 5th metatarsal articulation. Zone III stress fractures are chronic fractures that occur distal to the 4th and 5th metatarsal articulation and may be associated with cavovarus foot deformity. In children, it is important not to make the wrong diagnosis of a fracture of the proximal 5th metatarsal base while looking at a normal growth plate. The growth plate is usually present between the ages of 9-14 years of age, and it is parallel and lateral to the metatarsal. X-rays will show the fracture and its location. An acute Jones fracture will have sharp margins with no intramedullary sclerosis. A stress fracture will have a wide fracture line with medullary sclerosis. With nondisplaced fractures, use a boot or a cast and be non-weight bearing for 6-8 weeks. 75% of fractures will heal. For athletes or a displaced fracture, do a screw fixation of the fracture (very popular technique). In the lateral view, the canal appears to be straight and narrow. In the AP view, the 5th metatarsal appears to be curved (lateral bow). Lateral bow of the 5th metatarsal may cause complications during surgery. There is vulnerability at the midshaft for perforation of the medial cortex. The canal is narrower in the dorsal plantar dimension, which is narrow in the lateral view. The point of entry for the wire or the screw is not centered. The fifth metatarsocuboid joint blocks the proximal canal projection, and this situation can cause complications. Each patients metatarsal should be evaluated individually for proper screw selection. Drill parallel with the shaft in the lateral plane and avoid the plantar direction. Avoid the sural nerve. You will probably need to use a 4.5 mm cancellous screw. The appropriate length of the screw that should be used is usually around 40-50mm. The diameter of the screw depends on the width of the canal. The screw threads must cross the fracture site. Failure of the procedure is attributed to poor blood supply or return of the athlete to activity before complete radiographic union.

[@dryacoobomarcarrim3226]

The most comprehensive review of this topic ever. Excellent

[@jenniferdickman2812]

I got a Jones Fracture this weekend while kayaking and I am so appreciative of this video to better understand!

[@rolltidegaming1179]

I was playing basketball outside in my yard when I jumped to shoot the ball. I landed on my foot wrong to where it rolled inwards and fractured my foot on the landing. Two days later I went to the orthopedic to find out that I had a Jones fracture. I chose the non surgical option because I had never had an injury as serious as this one before and didn’t want to have surgery if it had a chance of healing on its own. I had to do eight weeks of non weight bearing in a cast. I just went back for my eight week appointment too. My doctor showed my X-rays and revealed that my fracture had pretty much completed filled back in and that it was healed. I just got put into a walking boot yesterday which I will be in for about three weeks along with physical therapy and I should be on my way to functioning normal again. If you have this fracture surgery is an option, but I can say from personal experience with this injury that it can heal properly without surgery as well. I’m an active 21 year old in good health, so I imagine that helped in the fracture healing process as well. I ate a diet largely focused on protein such as eggs and chicken, while also getting plenty of calcium by drinking milk and calcium supplements. I also took vitamin B and D supplements. I’m still on the road to recovery. This is only my second day in a walking boot and I still have to use crutches lightly to aid because of my foot and leg being sore from being in a cast for so long, but the pain is noticeably starting to go away since even yesterday. This is my personal experience with having a Jones fracture and I wish a speedy recovery to anybody reading that may be dealing with this same injury.

[@Manfredidu13]

Hi could you tell me how it evolved since then ? Was it a displaced or not displaced fracture ?

[@chadlouk66]

I just had this happen landing in sports as well. Any updates?😊

[@rolltidegaming1179]

@@Manfredidu13 mine was a not displaced fracture. It’s been a little over three months since the injury and I’m pretty much fully back to normal at this point. I’m finishing up my last week of physical training this week with full functionality back in my ankle and foot now

[@rolltidegaming1179]

Update: I officially was fully cleared a couple days ago so it took a little over 3 months for me to go from fracture to fully healed without surgery

[@Manfredidu13]

@@rolltidegaming1179 that's great news. I'm 1 month in and i'm doing a radiography check wednesday

[@DrusillaC]

Very helpful indeed. I have a Jones fracture and am at present wearing a boot but still in pain. I see the consultant next week so at least now I'll know what he's talking about. Thank you.

[@seekwisdom5102]

Did you have to do surgery or you are okay now?

[@nuraisyah1482]

@@seekwisdom5102 are you have jones fracture also? How your treatment? Surgery or natural healing?

[@seekwisdom5102]

@@nuraisyah1482 I don’t think mine was. No surgery. Wore boot no bearing for 10 days then walked bearing softly for the other 6 weeks. I did sleep with the boot at night. I cleaned and slept with it. Then I looked online for some physical therapy to regain strength on the foot, which was surprisingly weak. After that I wore shoes with insole all day, couldn’t be barefoot (weak foot). I still wear shoes and it is a bit sore sometimes. Its almost 3 months I guess.

[@MyProRc]

Hi did you heal naturally or need surgery? How are you now?

[@aniketrathod198]

I got Jones fracture while playing Basketball yesterday. I am on 8 weeks POP cast, Does it heal properly without Surgery??

[@lindanwfirefighter4973]

Great video! I learned a lot. Thank you.

[@MuhsinBillah]

thank you sir! i've got several patients with pseudo jones fracture .

[@alberto-4642]

Thanks doc !

[@bader41189]

Outstanding

[@thomas6963ify]

Jones fracture process succes for me Day:1-13 pain and swelling Day: 13-24 pain and swelling reduces day: 24-29 no more pain. a little swelling day: 29-52 no swelling or pain day: 53 x rays reveal reunion and full weight bearing (non weight bearing 6 weeks) Foods i ate: Almonds, 4 capsules fishoil a day, vitamin d/b/c/k(importnant!!!, eggs, almond milk, tuna, protein shakes, mackerel, rye bread, greens, bellpeppers, apples, and bananas. training: Gym weightlifting - but no exercises that put pressure on foot.

[@pri3032]

When were you able to walk properly.

[@thomas6963ify]

@@pri3032 8 weeks but after 6 weeks i could walk but just not as good.

[@jorambakker3765]

@@thomas6963ify you completely healed it by now??

[@Piyush_airy_]

@@thomas6963ify hello sir i have been cast for 7 weeks and my cast is removed but after removal of cast , Doctor does an xray in which like according to me bone hasn't healed like crack size was same as it was on 1st day but doctor said that bone is healing and you should start walking with a stick but when I try to walk my foot is in pain.

[@dhilipkumar5216]

@@Piyush_airy_ hi I'm having same type of scenario after 25 days doctor removed my cast but in xray the crack is still the same they told me to walk with a stick. How long it taken to fill the crack

[@deirdrewheeler5847]

Thank you so very much, very informative.

[@ibrahimalwahshi2507]

Excellent Video

[@ricardoquintero8502]

Great video Dr. Brilliantly explained.

[@orungbejatoluwani7363]

Very helpful indeed!!!

[@ecostavalenzuela]

Excelente presentación, muy clara y precisa. Muchas gracias

[@SinnerSince1962]

very good description, but plate fixation was not mentioned, and often may be the correct option.

[@laithhasm4380]

جزاك الله خير ..وكتب أجرك بالعلم النافع May u plz add rehabilitation for each # Many thanks

[@adammandelj5625]

Markiplier has this. Ouch

[@hfigo]

Grazie

[@seekwisdom5102]

Thanks

[@gregnettles3677]

I have a zone two.will need surgery next week uh

[@emcdvz5648]

Is there any medicine that can take for fast healing? I got stress fracture and i don't want to have a surgery as much as possible

[@nunyabussiness87]

Yabba wanna doo

[@seekwisdom5102]

Did you need surgery or you are all better now?

[@zanwermahmood1319]

thank you chairman

[@Piyush_airy_]

hello sir i have been cast for 7 weeks and my cast is removed but after removal of cast , Doctor does an xray in which like according to me bone hasn't healed like crack size was same as it was on 1st day but doctor said that bone is healing and you should start walking with a stick but when I try to walk my foot is in pain.

[@thebonedoctor4907]

0.42 *distal to the metatarsocuboid joint

[@chiafashionista]

Jus got back from ortho today, was told I have this and getting surgery in two days for it 🙁

[@MyProRc]

How bad was surgery and are you okay now? I assume your still in recovery?

[@chiafashionista]

@@MyProRc the first three weeks after surgery was painful and hard to sleep but its now three months later n i can walk perfectly and run n stand for long periods of time. as if it never happened. i did have to wear the boot n not walk on it for 6 weeks after surgery tho so that sucked

[@MyProRc]

@@chiafashionista I really appreciate you getting back to me! So happy to hear you are better now though and back to normal! It’s looks like I will be starting on that route here shortly. Did you use a bone stimulator and can you feel the screw at all?

[@chiafashionista]

@@MyProRc absolutely! no problem i know how it feels as i was searching the internet looking for answers or other shared experiences and couldnt find much! and no i did not use a bone stimulator and barley even remember the screw is there. only when weather is cold a little or when ive been walking really far itll feel like a tingle but no pain

[@MyProRc]

@@chiafashionista I totally appreciate you filling me in! That’s exactly how it is, the internet doesn’t have the exact answers you need so it’s been amazing being able to talk to you and get a first hand experience! I really really appreciate your help again and hope you are doing great and much better! I don’t have much to offer but if you ever need anything let me know! Thanks again! :)

[@user-hk9yg5im7k]

ধন্যবাদ

[@boobies8658]

Lmao markiplier

[@priyanshsingh3316]

That accent was sexy buddy

[@RainNelTolentino-dk8dp]

Markiplier have a jones fracture