Jones Fracture

What is a Jones fracture?

Jones fractures are a type of broken bone. They happen when you break your fifth metatarsal — the bone that joins your pinkie toe to the base of your foot.

Jones fractures are caused when you put sudden force on the outside of your foot with your foot twisted away from your body. Repeated overuse, sports injuries and falls are the most common causes of Jones fractures. You might need surgery to repair your bone. Most people need a few months to recover from a Jones fracture.

Jones fracture vs. avulsion fracture

Jones fractures and avulsion fractures are different types of bone fractures in your feet. In fact, they both refer to breaks of the same bone, your fifth metatarsal — the bone that joins your pinkie toe to the rest of your foot. The differences between Jones and avulsion fractures are small, but important.

Your fifth metatarsal has three zones along its length, starting from the base near the middle of your foot and extending out toward your toes. These zones tell your healthcare provider specific details about exactly where you broke your fifth metatarsal.

• Zone 1: The base of your metatarsal, where it joins the rest of your foot. Breaks in this zone are called avulsion fractures, dancer fractures, pseudo-Jones fractures or tennis fractures. These breaks are usually treated without surgery and heal in around two months after wearing a boot or cast.
• Zone 2: The middle part of your fifth metatarsal meets the base of Zone 1. If Zone 1 is the “head” of your fifth metatarsal, Zone 2 is the “body” extending out from it, further away from the middle of your foot. Fractures in Zone 2 are Jones fractures. Jones fractures usually require surgery, and have higher risks for complications than other types of foot fractures.
• Zone 3: The part of your fifth metatarsal that connects to your toe bones. Fractures in Zone 3 are usually stress fractures that take longer to heal and sometimes require surgery.

All of these names and terms can be confusing. No matter where your fracture is, the most important first step is getting your injury examined by a provider as soon as possible. They will explain which type of fracture you have and what you’ll need to do to fix it.

How common are Jones fractures?

Jones fractures are one of the most common foot fractures. They’re especially common in athletes, dancers and people with jobs that require them to be on their feet constantly.

Who gets Jones fractures?

Jones fractures — like all bone fractures — can affect anyone. You’re more at risk for a Jones fracture if you regularly put a lot of stress on your feet in ways most people don’t. Some examples of this include:

• Athletes.
• Dancers.
• Workers who walk or stand most of the time.

Men around 30 and women over 70 are also more likely to experience Jones fractures than other age groups.

People with osteoporosis have an increased risk for all types of broken bone, including Jones fractures.

What are the symptoms of a Jones fracture?

Symptoms of a Jones fracture include:

• Pain.
• Swelling.
• Tenderness.
• Difficulty walking like you usually can.
• Bruising or discoloration.
• A deformity or bump that’s not usually on your foot.

Displaced Jones fractures

Displaced or non-displaced are more words your provider will use to describe your fracture. A displaced fracture means the pieces of your bone moved so much that a gap formed around the fracture when your bone broke. Non-displaced fractures are still broken bones, but the pieces weren’t moved far enough to be out of alignment during the break. Displaced fractures are much more likely to require surgery to repair, non-displaced fractures are less likely to need surgery.

What causes Jones fractures?

Jones fractures are caused by a sudden impact to your foot while it’s twisted, usually with your heel lifted. Some of the most common causes include:

• Repeated overuse: Walking, running or standing on hard surfaces for too long.
• Sports injuries: Jumping like in basketball or dancing, or twisting quickly like in soccer or football.
• Falls and slips: Tripping on the stairs, or catching yourself suddenly after slipping on a wet floor, for example.

How are Jones fractures diagnosed?

Your healthcare provider will diagnose a Jones fracture with a physical exam and imaging tests.

What tests are done to diagnose a Jones fracture?

After a physical exam, you’ll likely need at least one of a few imaging tests:

• X-rays: An X-ray will confirm any Jones or other fractures and show how damaged your bones are.
• Magnetic Resonance Imaging (MRI): Your provider might use an MRI to get a complete picture of the damage to your bones and the area around them. This will show them tissue around your bones too. This is especially important to determine if your muscles or connective tissue were injured.
• CT scan: If you need surgery, your provider or surgeon needs to know exactly how damaged your bones are. A CT scan will give them a more detailed picture of your bones and the surrounding tissue than an X-ray.

How are Jones fractures treated?

How your Jones fracture is treated depends on the severity of the original break. Your broken bones need to heal back together. Depending on how damaged they are and what caused them to break, there are a few treatments your provider might use.

Immobilization

If your break is mild and the bones did not move far out of place (if it’s non-displaced), you might only need a cast or boot. You’ll typically wear them for six to eight weeks. In both cases you’ll likely need to follow up X-rays to make sure your bones are healing correctly.

Closed reduction

More severe breaks require a closed reduction to set (realign) your bones. During this non-surgical procedure, your provider will physically push and pull your body on the outside to line up your broken bones on the inside. To prevent you from feeling pain during the procedure you’ll receive one of the following:

• Local anesthetic to numb the area around your fracture.
• Sedatives to relax your whole body.
• General anesthesia to make you sleep through the procedure.

After the closed reduction, your provider will put you in a cast or boot.

Jones fracture surgery

Internal fixation

The most intense fractures require surgery. Your surgeon will realign (set) your bones to their correct position and then secure them in place so they can heal and grow back together. They usually perform what’s called an internal fixation, which means your surgeon inserts pieces of metal into your bone to hold it in place while it heals. Internal fixation techniques include:

• Rods: A rod inserted through the center of your bone that runs from top-to-bottom.
• Plates and/or screws: Metal plates screwed into your bone to hold the pieces together in place.
• Pins and wires: Pins and wires hold pieces of bone in place that are too small for other fasteners. They’ll typically be used at the same time as either rods or plates.

Some people live with these pieces inserted in them forever. You might need follow-up surgeries to remove them.

Bone grafting

You might need bone grafting if your Jones fracture is severely displaced or if your bone isn’t healing back together as well as it should. Your surgeon will insert additional bone tissue to rejoin your fractured bone. After that, they’ll usually perform an internal fixation to hold the pieces together while your bone regrows. Bone grafts can come from a few sources:

• Internally from somewhere else in your body — usually the top of your hip bone.
• An external donor.
• An artificial replacement piece.

Jones fracture surgeries are usually outpatient procedures, and you should be able to go home the same day.

After your surgery, your foot will be immobilized. You’ll need to wear a boot or cast before you can start putting any weight on it again or using it like you did before your fracture.

What medications are used to treat Jones fractures?

Over-the-counter NSAIDs like aspirin or ibuprofen can lead to bleeding and other complications after surgery. Your surgeon will talk to you about the medications you can take to reduce pain after your surgery.

Complications of Jones fracture treatment

Jones fracture surgery complications include:

• Acute compartment syndrome (ACS): A build-up of pressure in your muscles may stop blood from getting to tissue, which can cause permanent muscle and nerve damage.
• Malunion: This happens when your broken bones don't line up correctly while they heal.
• Nonunion: Your bones may not grow back together fully or at all. Jones fractures have some of the highest risks of nonunion for all broken bones. As many as one in three people experience nonunion.
• Other internal damage: Fractures can damage the area around the injury including your muscles, nerves, blood vessels, tendons and ligaments.
• Refracture: Jones fractures have a higher risk of breaking again than other broken bones.

Side effects of NSAIDs include:

• Bleeding.
• Ulcers.
• Stomach pain.
• Bowel complications.

How soon after treatment will I feel better?

It could take a few weeks for your symptoms to improve before you can begin walking again. Depending on which type of surgery you have, you might not be able to put weight on your foot for up to eight weeks. Gradually, you’ll be able to add in more activity. You should be able to resume all your normal activities — including playing sports — in 3 to 4 months.

If you experience intense pain that doesn’t get better contact your healthcare provider right away.

How can I reduce my risk for Jones fractures?

Follow these general safety tips to reduce your risk of an injury:

• Wear the right protective equipment for all activities and sports.
• Make sure your home and workspace are free from clutter that could trip you or others.
• Always use the proper tools or equipment at home to reach things. Never stand on chairs, tables or countertops.
• Follow a diet and exercise plan that will help you maintain good bone health.
• Talk to your provider about a bone density test if you’re older than 50 or if you have a family history of osteoporosis.

How can I prevent a Jones fracture?

Avoid overusing your feet if possible. Give your body time to rest and recover after intense physical activity. If you use a walker or cane to help walk, never try walking without it. Be sure to be careful while walking on uneven surfaces.

What can I expect if I have a Jones fracture?

If you have a Jones fracture, you should expect to make a full recovery. You will need physical therapy to regain strength and range of motion in your foot.

How long does it take a Jones fracture to heal?

How long it takes you to heal depends on the severity of your fracture and which treatments you needed. Most people need three to four months to recover from a Jones fracture.

Complications like nonunion or refracture will extend your healing time. It’ll also take your body longer to heal if you need bone grafting to repair your Jones fracture.

Will I need to miss work or school?

If you can do your job or studies with your foot immobilized you shouldn’t need to miss work or school.

Talk to your surgeon or healthcare provider before resuming any physical activities while you’re recovering.

Outlook for a Jones fracture

The outlook for Jones fractures is positive. Even if you need surgery, you should make a full recovery.

When should I go to the emergency room?

If you think you have a Jones fracture — or any other broken bone — you need to see a healthcare provider as soon as possible. Go to the emergency room if you experience any of the following:

• Intense pain.
• You can’t move a part of your body that you normally can.
• A part of your body is noticeably different looking or out of its usual place.
• You can see your bone through your skin.
• Swelling.
• New bruising that appears at the same time as any of these other symptoms.

Go to the emergency room right away if you’ve experienced a trauma.

What questions should I ask my doctor?

• Which bones are fractured?
• Do I have a Jones fracture or another type of fifth metatarsal break?
• Will I need surgery?
• How long will it take to recover?
• When can I resume physical activities?

A note from Cleveland Clinic

A Jones fracture can be confusing, especially when you find playing your favorite sport like you always have has caused you to miss months of games or performances. Even if you need surgery, Jones fractures respond well to treatment, and you should make a full recovery. Make sure you talk to your provider about how you can keep your bones strong and healthy, and get regular bone density screenings if you’re older than 50 or have a family history of osteoporosis.