Fifth Metatarsal Fractures (Jones & Dancer's)
Whilst dancing, I trod on the outer side of my foot, my heel at the moment being off the ground. Something gave way midway down my foot, and I at once suspected a rupture of the peroneus longus tendon... I hobbled down-stairs to my colleague…to X-ray my foot. This was done, and the fifth metatarsal was found fractured about three-fourths of an inch from its base - Sir Robert Jones, 1902
HWN Suggests
Fifth metatarsal fractures: an update on management, complications, and outcomes
Even though fifth metatarsal fractures represent one of the most common injuries of the lower limb, there is no consensus regarding their classification and treatment, while the term ‘Jones’ fracture has been used inconsistently in the literature...
Metatarsal fractures represent the most common injury of the foot, accounting for approximately 5–6% of all the fractures encountered in the primary care setting, with about 45–70% of these injuries involving the fifth metatarsal... Nowadays, the term ‘Jones fracture’ defines just one type of the fifth metatarsal fracture, that is a ‘Zone 2’ injury, and there are several misconceptions and controversies regarding the terminology and treatment…
Featured
Fractures of the Distal Shaft of the Fifth Metatarsal: "Dancer's Fracture"
Spiral fractures of the distal shaft of the fifth metatarsal are common injuries and can usu ally be treated nonoperatively for these high perfor mance athletes without long-term functional sequelae.
Jones Fracture
Fracture of the proximal diaphysis of the 5th metatarsal, distal to the tuberosity, without joint involvement. Caused by foot inversion / twisting and repetitive stress The term ‘Jones fracture’ is used inconsistently; some referring to fracture at the metaphyseal-diaphyseal junction and others define it as a fracture at the proximal diaphysis. The ‘Zone I, II, III‘ method of description is more accurate, replicable and assists in determining immediate treatment and ongoing management.
Articles of Interest
5th Metatarsal Fracture
The symptoms of a 5th Metatarsal fracture are variable with some people reporting no pain, bruising, or swelling while others are unable to walk on a 5th Metatarsal Fracture. When there is pain present, this is usually along the 5th metatarsal with pain on palpation of the bone. It is usually painful to hop on the affected foot and it is painful immediately on weight-bearing with pain ease in a non-weight bearing position.
5th Metatarsal Shaft “Dancer’s” Fracture
A 5th metatarsal shaft “Dancer’s” fracture is an injury that is usually treated non-operatively. The fracture has a very high rate of healing with non-operative treatment. Treatment involves relative rest and time to allow the fracture to heal. Typically, patients are placed in a walking boot. Although weight bearing is allowed, for the first few weeks, they will have to significantly limit their walking and may need crutches due to pain and discomfort.
5th Metatarsal Shaft “Dancer’s” Fracture
A twisting injury to the ankle and foot may cause a long fracture of the 5th metatarsal shaft — the bone that attaches the little toe to the midfoot (Figure 1). During this injury, the 5th metatarsal is twisted by a strong force resulting in a spiral fracture. This 5th metatarsal “Dancer’s” fracture causes localized pain, swelling, and difficulty walking. In many instances, this type of fracture can be treated non-operatively, with relative immobilization in a walking boot combined with limited weight-bearing. It typically takes about 6 weeks for adequate bone healing to occur, before patients can start to significantly increase their activity level. It often takes 4 or more months for a full recovery to occur. There is another fracture that may also be referred to as a dancer’s fracture. However, since this fracture of the fifth metatarsal was first described in ballet dancer’s, it has become known as a dancer’s fracture as well.
Avulsion fracture of the 5th metatarsal styloid
Avulsion fracture of the 5th metatarsal styloid, also known as a pseudo-Jones fracture or a dancer fracture, is one of the more common foot avulsion injuries and accounts for over 90% of fractures of the base of the 5th metatarsal.
Metatarsal Fractures
5 to 6% of all fractures treated in primary care are metatarsal fractures. It are the most common injuries of the foot. They are about ten times as frequent as Lisfranc-dislocations.[11]They are equally among men and women and among all racial groups.
Resources
WikEM
Dancer, pseudo-Jones, or tuberosity (styloid) avulsion fracture. Most common fracture at base of 5th metatarsal. Jones or metaphyseal-diaphyseal junction fracture, Second most common fracture at base of 5th metatarsal. Diaphyseal stress fracture
