admin@thefeetpeople.com.au

(07) 3356 3579

BOOK NOW
BOOK NOW

Jump to section

What is a Jones fracture?
Symptoms
The problem with a Jones fracture
Causes
Diagnosis
Treatment
Recovery and rehab
Can it cause complications?
Prevention
FAQs

A Jones fracture is a type of avulsion fracture that occurs at the base of your fifth toe, around the midfoot on the outer side of the foot. It can cause pain and tenderness, while making it difficult to bear weight on the affected foot.

What Is A Jones Fracture?

While a regular fracture describes a break or crack in a bone, an avulsion fracture is a special type of fracture that occurs when part of a bone that is attached to a tendon or ligament is broken off from the rest of the bone. It is usually the strain and pull from the connecting tendon that leads to the fracture, compounded by a range of other factors (see ‘causes’ below).

In the case of the Jones fracture, the area of bone that is broken is from the base of the fifth metatarsal - meaning the long bone of the foot that connects to the small (pinky) toe. Run your fingers along the outside edge of your foot and you’ll be able to feel a bump around the outer midfoot called the styloid process. This bony bump is where the tendon of the peroneus brevis muscle occurs, which stays connected to the small piece of fractured bone in this injury.

Symptoms Of A Jones Fracture

While symptoms may differ depending on the severity of your injury and any other injuries that may have occurred at the same time, you may experience:

• Pain on the outer side of the foot, near the base of the fifth metatarsal. This pain can range from mild discomfort to severe and sharp, especially with weight-bearing activities or pressure on the affected area.
  

• Inflammation and swelling with accompanying tenderness and warmth upon touching. Swelling can exacerbate the pain and restrict movement in the foot.
  

• Bruising or discoloration if bleeding has occurred within the soft tissues. The bruising can appear red, purple, or blue and can spread to cover a larger area on the side or top of the foot.
  

• Tenderness on walking or bearing weight on the affected foot, which can make it difficult to perform daily tasks. It is not uncommon to limp with a Jones fracture or try walking on the inside edge of the foot to try to avoid pain.
  

• Reduced movement in the foot and ankle. Movements like lifting the foot upward (dorsiflexion) or pointing the foot downward (plantarflexion) may be restricted or uncomfortable.
  

• Difficulty wearing shoes comfortably, particularly if the shoes rub along the outside of the foot.
  

The Problem With A Jones Fracture

The tricky thing about a Jones fracture is that it tends to be more difficult to heal, as the area of the styloid process where the fracture occurs has a poorer blood supply than other areas of the foot. This can make healing and repair a longer process, meaning that doing what we can to effectively support the bone in healing efficiently and correctly is important to help prevent future discomfort and reduce the risk of reinjury.

Causes Of A Jones Fracture

In many cases, a Jones fracture occurs together with an ankle sprain, when the foot suddenly and forcefully turns inwards while the ankle rolls outwards. Other times, it is caused by overuse, with repetitive high levels of stress and strain on the bones of the outer foot (or the tendons that connect to it) progressively causing damage until the ‘breaking point’ occurs and the bone fractures. Those engaging in running, jumping, or dancing sports are particularly at risk here, as well as athletes who may have a rigorous training schedule without sufficient rest.

Other causes of a Jones fracture can include trauma to the outer foot through falls or direct blows, as well as poor foot biomechanics (including flat feet and high arches) due to the way they can alter the distribution of forces and weight-bearing patterns across the foot, placing increased stress on specific areas, including the fifth metatarsal bone.

Diagnosing A Jones Fracture

Diagnosing a Jones fracture involves a comprehensive biomechanical exam with our podiatrists where we evaluate the injury and understand the likely causes and contributing factors. Because the nature of an injury at the base of the fifth metatarsal can vary greatly - ranging from a minor injury to a stress fracture to an avulsion fracture, medical imaging may be recommended so we can confirm the diagnosis, understand its severity, and assess the surrounding bones and tissues for any other injuries that may be compounding your symptoms. This information will guide our treatment plan and help ensure you get the best care for your unique circumstances.

Treating A Jones Fracture

At home treatment

If you suspect that you have a Jones fracture, you can start supporting your foot at home by following the PRICE principles: 

• Protecting the foot from external forces and more damage
  
• Resting the foot where possible. Ideally you want to try to immobilise the foot entirely - trying to not bear weight on the foot where possible and using any assistive devices you may already have lying around such as crutches
  
• Icing the foot by applying ice through a cloth or tea towel (or other protective barrier to avoid direct skin contact) - apply for no more than 20 minutes at a time, 4 times per day, to help with swelling
  
• Compressing the foot using bandages, tape or other wraps to help limit swelling and offer greater protection
  
• Elevating the foot (ideally at heart level) to help reduce inflammation and swelling, which eases painful symptoms
  

Most importantly, you should book an appointment with your podiatrist so you can start your road to recovery and help prevent your injury and pain from worsening. This is especially important given that these fractures take longer to heal than regular fractures.

Podiatrist Treatment

After your assessment, your podiatrist will discuss your available treatment options and make recommendations as to the best options given your unique circumstances. It is likely that we may recommend offloading or immobilising your foot using a walker or moon boot. Following this, and depending on your symptoms or progress, we may the recommend: 

• Custom foot orthotics that alleviate pressure and tension from the outside border of the foot and the fracture site, both supporting healing and repair now and helping protect against future re-injury
  
• Ankle-foot orthotics to help with stability and offloading, working in a similar way to an orthotic but encompassing the lower leg, too.
  
• Assessing the shoes you wear daily to ensure they have enough supportive features to best support your recovery, and aren’t hindering your progress
  
• Footwear modifications, if needed, to help your shoes do their best job of supporting your feet, redistributing excess pressure and optimising your gait
  
• Activity modifications (temporarily) to best support healing and repair
  
• Once significant healing and repair has occurred, we may use physical therapy to address any muscle imbalances that may have contributed. It’s important to not start physical therapy too early with a Jones fracture, as this can significantly worsen the injury and your symptoms.
  
• MLS laser for pain relief and accelerated healing and repair
  

Surgical Treatment

In complex cases, if the fifth metatarsal fails to heal, we can refer you to an orthopaedic surgeon. All orthopaedic surgical procedures are serious and conservative (non-surgical) measures should typically be attempted first. Surgical treatment options for a Jones fracture may involve internal fixation to stabilise the fractured bone and promote proper healing. One common surgical technique is open reduction and internal fixation (ORIF), where the surgeon makes an incision over the fracture site, realigns the bone fragments into their proper position, and secures them with screws, plates, or wires. Another is called intramedullary fixation, where a metal screw or rod is inserted into the medullary canal of the fifth metatarsal to stabilise the fracture internally. Your surgeon will go through all of your available options, including their benefits and risks.

Recovery And Rehabilitation

Following a Jones fracture, the timeline for healing can vary but generally may take approximately 6 to 12 weeks for non-surgical treatment and may extend longer following surgery. Full symptom relief may take even longer at times, with a gradual improvement in pain, swelling, and mobility over time.

As your healing progresses, a gradual return to activities and sports can be started when deemed safe to do so by your podiatrist or surgeon. Initially, we’ll prescribe a range of gentle range-of-motion exercises and non-weight-bearing activities to help with foot mobility. As symptoms improve and bone healing is confirmed through imaging studies, the intensity and duration of physical activity can be gradually increased, again taking extreme care not to go too hard too fast and worsen the injury.

Can A Jones Fracture Cause Complications?

Yes, a Jones fracture can lead to complications in some cases, including:

• Delayed healing, where the bone takes longer than expected to mend. Factors such as the severity of the fracture, poor blood supply to the area, underlying medical conditions or even prolonged immobilisation can contribute to delayed healing. This means a longer recovery and time and often a more aggressive approach to recovery.
  

• Nonunion or malunion of the bone: if the bone doesn’t set in the right alignment and or with sufficient stability, a Jones fracture may fail to heal completely, leading to what is called ‘nonunion’ or ‘malunion’. Nonunion occurs when the fractured bone fails to heal within the expected timeframe, while malunion refers to improper alignment of the healed bone fragments.
  

• Chronic pain can result from nerve damage, inflammation, or changes in joint mechanics due to the injury. Inadequate rehabilitation, biomechanical abnormalities, or underlying foot conditions may also contribute to ongoing pain.
  

• Future risk of re-injury: those who have experienced a Jones fracture are at an increased risk of re-injury, especially if preventive measures are not taken. Factors such as poor foot mechanics, inadequate footwear, or returning to high-impact activities too soon can increase the likelihood of recurrence. Reinjury may result in further damage to the fifth metatarsal bone, prolonging recovery time and increasing the risk of complications.
  

Preventing A Jones Fracture

While you may not be able to prevent a Jones fracture completely, there are definitely steps you can take to reduce your risk of the fracture, whether it’s a first or subsequent fracture injury. Wearing good, supportive footwear with sufficient cushioning, arch support, and stability can help distribute pressure evenly across the foot, reducing the strain on the fifth metatarsal bone during activities. If you have custom foot orthotics, it’s important to continue to wear these and keep them in your shoes, particularly when you’re engaged in physical activity or up on your feet. 

Additionally, incorporating strengthening and flexibility exercises into a regular exercise routine can improve foot and ankle stability, enhancing resilience against injury. You want to avoid sudden increases in physical activity and instead, gradually progress in your exercise intensity to allow the foot to safely adapt to the demands placed on it.

Frequently Asked Questions (FAQs)

What is the recovery time for a Jones Fracture?

The recovery time for a Jones fracture really can vary notably depending on factors such as the severity of the fracture, the chosen treatment approach, how well you adhere to measures like offloading and immobilising, and your individual healing factors. In general, non-surgical treatment may take approximately 6 to 8 weeks for the bone to heal, and then up to 12 weeks for full symptom relief. Surgical treatments may have a longer recovery period. Generally, it’s important to manage your expectations and know that a full recovery and return to normal activities may take several months, and it's very important not to go too hard too fast or overdo it on your feet throughout your recovery so that you don’t set yourself backwards.

Can I still exercise with a Jones Fracture?

Not without clearance from your podiatrist or surgeon, after the bone has sufficiently healed and strength has been restored. If you put too much weight or stress on the injured foot too early, it can cause further damage and demote proper healing. As symptoms improve and the bone heals, you’ll be able to start incorporating low-impact activities that do not exacerbate pain or strain on the foot, such as swimming or cycling. Once significant healing and repair has occurred, you’ll be able to work your way up to activities as normal.

Is surgery always necessary for treating a Jones Fracture?

No, surgery is not always necessary for treating a Jones fracture and it depends on factors such as the severity of the fracture, displacement of the bone fragments, and your unique circumstances. We will go over all of your treatment options at your appointment and refer you to an orthopaedic surgeon if needed.