Fractures of the base of the fifth metatarsal: the Jones fracture

The Jones fracture continues to be a problem fracture for the orthopedic surgeon and sports medicine physician. This injury seems to occur in athletes as well as nonathletes. The underlying inherent poor blood supply of the proximal metaphyseal diaphyseal region makes the fifth metatarsal a difficult bone to unite. Many techniques have been advocated for the treatment of this troublesome fracture, including non-weight-bearing short leg casting, orthotic management, open reduction and internal fixation, corticocancellous onlay bone grafting, and electric stimulation. The author believes that in young athletic patients, using meticulous surgical technique, reliable open reduction and internal fixation yields excellent results. In nonathletic or less demanding patients, the patient should participate in the discussion and choice of the treatment techniques. If delayed union or non-union occurs, drilling with the use of internal fixation usually produces a union.