Classically, treatment consists of weight bearing restrictions in a cast or surgical fixation. Successful outcomes are based on precise surgical technique. Jones fractures, or proximal metatarsal fractures at the level of the fourth and fifth intermetatarsal junction, have a high risk for nonunion due to a vascular watershed region. Multiple studies have reported high rates of union with surgical fixation. Open reduction and internal fixation with the use of an intramedullary screw and supplemental calcaneal autograft is a successful treatment option for the management of Jones fracture nonunions. The postoperative rehabilitation protocol and outcomes after fixation of Jones fracture nonunions are then reviewed.Īfter a technically successful surgery, the patient progressed through our standard Jones fracture postoperative rehabilitation protocol, which resulted in successful union of the fracture. The video reviews the case presentation of a patient with a Jones fracture nonunion who underwent intramedullary screw fixation with the use of supplemental calcaneal autograft. The video reviews the epidemiology, pathology, and diagnosis of Jones fractures, specifically nonunions, and discusses treatment options and indications for surgical management. Broken Foot Causes Symptoms When to See a Healthcare Provider Diagnosis Treatment A broken foot, or foot fracture, can affect any of the 26 different bones in each foot. This video provides an overview on Jones fractures and discusses the case presentation of a patient with a Jones fracture nonunion managed via open reduction and internal fixation with the use of an intramedullary screw and calcaneal autograft. With precise technique, open reduction and internal fixation of Jones fracture nonunions with the use of an intramedullary screw and calcaneal autograft affords successful healing. In patients with a Jones fracture nonunion, intramedullary screw fixation is associated with a 97% union rate. Intramedullary screw fixation for the management of fractures of the base of the fifth metatarsal is associated with a high rate of union. All symptomatic Jones fracture nonunions warrant surgical management in patients without medical comorbidities that preclude surgery. Imaging studies of Jones fracture nonunions are notable for obliteration of the intramedullary canal from sclerosis. Because of a vascular watershed area, Jones fractures do not typically heal, leading to nonunion. Jones fractures are a subset of fifth metatarsal base fractures, occurring at the articulation between the fourth and fifth metatarsals. Fractures of the base of the fifth metatarsal are common injuries managed by orthopaedic surgeons. It is a transverse fracture at the base of the fifth metatarsal, 1. » Percutaneous fixation of Jones fractures with an intramedullary screw is the standard of care for athletes, who experience unacceptably high rates of nonunion, refracture, and delayed return to activities with nonoperative treatment.
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