Functional outcome of intramedullary screw fixation of fifth metatarsal Jones fracture

Authors

  • Kundan Kushwah Department of Orthopaedics, MGM Medical College, Indore, India
  • Deepak Singh Rajput Department of Orthopaedics, MGM Medical College, Indore, India
  • Manu Mahesh Kumar Department of Orthopaedics, MGM Medical College, Indore, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20253423

Keywords:

AOFAS, Jones fracture, Operative treatment, Union time

Abstract

Background: Management of fractures of the base of 5th metatarsal has long been a topic of debate, particularly regarding the effectiveness of operative and non-operative treatment approaches. This study aimed to evaluate the outcomes of internal fixation using an intramedullary screw in management of Jones fracture.

Methods: Twenty-one patients diagnosed with Jones fracture were surgically fixed with intramedullary screw and were evaluated on the basis of union time and the American Orthopaedic Foot and Ankle Society score at 6 weeks and 12 weeks.

Results: Overall union time of the study patients was 6.76 weeks (SD=0.768). There was a non-significant relationship between age and union time (r=0.146, p=0.528) in the patients. The overall mean AOFAS score at 6 weeks increased from 87.43±5.005 to overall mean score 94.09±2.364 at 12 weeks after treatment. There was a significant negative correlation between age and AOFAS at 6-weeks (r=-0.673, p<0.001) and at 12-weeks (r=-0.542, p=0.011) post treatment.

Conclusions: The treatment with surgical screw fixation is safe and effective method for treatment of acute Jones fracture and can be strongly recommended in those who want to return to normal activity earlier.

 

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References

Balaji G, Nema S, Kumar A. A study on epidemiology of foot injuries in South Indian population at a tertiary care centre. Int J Res Orthop. 2020;6(5):1063-9. DOI: https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20203732

DeVries JG, Taefi E, Bussewitz BW, Hyer CF, Lee TH. The fifth metatarsal base: anatomic evaluation regarding fracturemechanism and treatment algorithms. J Foot Ankle Surg. 2015;54(1):94-8. DOI: https://doi.org/10.1053/j.jfas.2014.08.019

Lawrence SJ and Botte MJ. Jones’ fractures and related fractures of the proximal fifth metatarsal. Foot and Ankle. 1993;14:358–65. DOI: https://doi.org/10.1177/107110079301400610

Yates J, Feeley I, Sasikumar S, Rattan G, Hannigan A, Sheehan E. Jones fracture of the fifth metatarsal: is operative intervention justified. A systematic review of the literature and meta-analysis of results. Foot. 2015;25:251–7. DOI: https://doi.org/10.1016/j.foot.2015.08.001

Nunley JA. Jones fracture technique. Techn Foot Ankle Surg. 2002;1(2):131-7. DOI: https://doi.org/10.1097/00132587-200212000-00007

Abdelsalam AE, Mautog AFA, Gerges FSF. Evaluation of Internal Fixation of Base of Fifth Metatarsal Fracture of the Foot by Screw. The Egyptian J Hospital Med. 2022;87:1684-90. DOI: https://doi.org/10.21608/ejhm.2022.229373

Mahajan V, Chung HW, Suh JS. Fractures of the proximal fifth metatarsal: percutaneous bicortical fixation. Clin Orthop Surg. 2011;3(2):140-6. DOI: https://doi.org/10.4055/cios.2011.3.2.140

Kaushik S, Vema RK, Gupta SP, Bhairava R. Evaluation of efficacy of different modalities in treatment of fracture metatarsal. Asian J Pharm Clin Res 2021;14(5):140-43. DOI: https://doi.org/10.22159/ajpcr.2021.v14i5.41218

Kingery MT, Kadiyala ML, Walls R. Clinical and radiographic healing of nonoperative and operative treatment of jones fractures. Foot Ankle Int. 2024;45(4):309-17. DOI: https://doi.org/10.1177/10711007241227931

Porter DA, Duncan M, Meyer SJ. Fifth metatarsal Jones fracture fixation with a 4.5-mm cannulated stainless-steel screw in the competitive and recreational athlete: a clinical and radiographic evaluation. American J Sports Med. 2005;33(5):726–33. DOI: https://doi.org/10.1177/0363546504271000

Granata JD, Berlet GC, Philbin TM, Jones G, Kaeding CC, Peterson KS. Failed surgical management of acute proximal fifth metatarsal (Jones) fractures: a retrospective case series and literature review. Foot and Ankle Spec. 2015;8:454–9. DOI: https://doi.org/10.1177/1938640015592836

Metzl J, Olson K, Davis WH, Jones C, Cohen B, Anderson R. A clinical and radiographic comparison of two hardware systems used to treat jones fracture of the fifth metatarsal. Foot Ankle Int. 2013;34(7):956-61. DOI: https://doi.org/10.1177/1071100713483100

Said ABZ. Early screw fixation versus casting in the treatment of acute Jones fracture. Egypt Orthopaed J. 2021;55(1):40-7. DOI: https://doi.org/10.4103/eoj.eoj_11_21

Scott RT, Hyer CF & DeMill SL. Screw fixation diameter for fifth metatarsal jones fracture: a cadaveric study. J Foot Ankle Surg. 2015;54:227–9. DOI: https://doi.org/10.1053/j.jfas.2014.11.010

Ochenjele G, Ho B, Switaj PJ, Fuchs D, Goyal N & Kadakia AR. Radiographic study of the fifth metatarsal for optimal intramedullary screw fixation of Jones fracture. Foot Ankle Internat. 2015;36:293–301. DOI: https://doi.org/10.1177/1071100714553467

Portland G, Kelikian A, Kodros S. Acute Surgical Management of Jones’ Fractures. Foot & Ankle Int. 2003;24(11):829-33. DOI: https://doi.org/10.1177/107110070302401104

Martina M, Alexandre M, Jorge R, Leanrdo J. Intramedullary screw fixation of proximal 5th metatarsal fracture in athelets. Actaortop Bras. 2012;20:262–5.

Yoho RM, Vardaxis V, Dikis J. A retrospective review of the effect of metatarsus adductus on healing time in the fifth metatarsal jones fracture. Foot (Edinb). 2015;25(4):215-9. DOI: https://doi.org/10.1016/j.foot.2015.05.006

Bucknam RB, Scanaliato JP, Kusnezov NA, Heida KA Jr, Dunn JC, Orr JD. Return to Weightbearing and High-Impact Activities Following Jones Fracture Intramedullary Screw Fixation. Foot Ankle Int. 2020;41(4):379-386. DOI: https://doi.org/10.1177/1071100719898278

Delee JC, Evans JP, Julian J. Stress fracture of the fifth metatarsal. American J Sports Med. 1983;11(5):349-53.

Bassiooni H, Ahmed A, Abou Zied M, Elgamal H. Comparative Study between Primary Surgical Intervention and Conservative Management in Cases of Jones Fracture of Base 5th Metatarsal Bone. Benha J Appl Sci. 2021;6(2): 39-45. DOI: https://doi.org/10.21608/bjas.2021.167856

Kim HN, Park YJ, Kim GL, Park YW. Closed antegrade intramedullary pinning for reduction and fixation of metatarsal fractures. J Foot Ankle Surg. 2012;51(4):445-9. DOI: https://doi.org/10.1053/j.jfas.2012.04.009

Vorlat P, Achtergael W, Haentjens P. Predictors of outcome of non-displaced fractures of the base of the fifth metatarsal. Int Orthop. 2007;31(1):5-10. DOI: https://doi.org/10.1007/s00264-006-0116-9

Bigsby E, Halliday R, Middleton RG, Case R & Harries W. Functional outcome of fifth metatarsal fractures. Injury. 2014;45:2009–12. DOI: https://doi.org/10.1016/j.injury.2014.06.010

Pflüger P, Zyskowski M, Müller, M. Functional outcome of 103 fractures of the proximal fifth metatarsal bone. Eur J Med Res. 2021;26:150. DOI: https://doi.org/10.1186/s40001-021-00623-6

Mostafa FR, M. Surgical Treatment of Fracture Base of Fifth Metatarsal in Adults. J Clin Case Rep. 2018;8:1078. DOI: https://doi.org/10.4172/2165-7920.10001078

Massada MM, Pereira MA, de Sousa RJ, Costa PG, Massada JL. Intramedullary screw fixation of proximal fifth metatarsal fractures in athletes. Acta Ortop Bras. 2012;20(5):262-5. DOI: https://doi.org/10.1590/S1413-78522012000500003

Glasgow MT, Naranja RJ, Glasgow SG, Torg JS. Analysis of Failed Surgical Management of Fractures of the Base of the Fifth Metatarsal Distal to the Tuberosity: The Jones Fracture. Foot Ankle Int. 1996;17(8):449-57. DOI: https://doi.org/10.1177/107110079601700803

Kavanaugh JH, Brower TD, Mann RV. The Jones fracture revisited. J Bone Joint Surg Am. 1978;60(6):776-82. DOI: https://doi.org/10.2106/00004623-197860060-00008

Wright RW, Fischer DA, Shively RA, Heidt RS, Nuber GW. Refracture of Proximal Fifth Metatarsal (Jones) Fracture After Intramedullary Screw Fixation in Athletes. The American J Sports Med. 2000;28(5):732-6. DOI: https://doi.org/10.1177/03635465000280051901

Donley BG, McCollum MJ, Murphy GA, Richardson EG. Risk of sural nerve injury with intramedullary screw fixation of fifth metatarsal fractures: a cadaver study. Foot Ankle Int. 1999;20(3):182-4. DOI: https://doi.org/10.1177/107110079902000308

Delee JC, Evans JP, Julian J. Stress fracture of the fifth metatarsal. American J Sports Med. 1983;11(5):349-53. DOI: https://doi.org/10.1177/036354658301100513

Hunt KJ, Anderson RB. Treatment of Jones fracture nonunions and refractures in the elite athlete: outcomes of intramedullary screw fixation with bone grafting. American J Sports Med. 2011;39(9):1948-54. DOI: https://doi.org/10.1177/0363546511408868

Stefan R, Jan H, Hans Z. Metatarsal fractures. Injury. 2004;35:77-86. DOI: https://doi.org/10.1016/j.injury.2004.07.016

Zwitser EW, Breederveld RS. Fractures of the fifth metatarsal; diagnosis and treatment. Injury. 2010;41:555-62. DOI: https://doi.org/10.1016/j.injury.2009.05.035

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Published

2025-10-27

How to Cite

Kushwah, K., Rajput, D. S., & Kumar, M. M. (2025). Functional outcome of intramedullary screw fixation of fifth metatarsal Jones fracture. International Journal of Research in Orthopaedics, 11(6), 1467–1472. https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20253423

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Original Research Articles