What is a Jones Fracture and How Do You Treat it?
- Posted on: Mar 26 2019
Your foot is structured by numerous bones that are categorized into bones of the hind foot, mid foot, and forefoot. In the mid foot, there are 5 long bones called metatarsals and each of these bones connects the back of the foot to your toes. A Jones’ fracture is a break in the 5th bone that connects to your 5th, or smallest, toe, also known as the “pinky toe”. It is named after Sir Robert Jones, who first identified the injury in 1902. It is the most severe type of break that can occur in this bone and usually requires increased time to heal due to poor blood circulation. Typical symptoms of a fracture in this area includes pain with walking, swelling, and bruising which can occur suddenly while standing or placing weight through the foot. Due to the location of the fracture, it is most typically sustained while placing weight on the foot while both the toes are positioned downward and the foot is positioned slightly inward, or supinated. However, it should be noted that in individuals with osteoporosis, this break can occur suddenly while walking on uneven surfaces or while stepping off of a ledge as the bone is more brittle in this area and therefore more susceptible to injury due to increased stress on the bone.
A Jones’ fracture can be diagnosed by touching the base of the metatarsal where there is a slight natural bulge to the bone to see if there is pain in conjunction with symptom presentation, but best diagnosis is usually by X-ray. Once confirmed, if the break is simple, treatment usually includes casting or placement into a surgical shoe or a walking boot to offload the area and allow for appropriate healing in a non-weight bearing position x 6 weeks. However, if the break is displaced, or angulated, surgical intervention may be required to appropriately realign the bone. Whether the foot is treated conservatively, or surgically, the bone may take up to 12 weeks to effectively heal. During this time, weakness in the surrounding muscles is most likely to occur due to decreased use, resulting in further instability of the foot as well as altered walking pattern which then places strain on the knee and hip joint
Once the bone is considered stabilized by your physician, you may be referred to physical therapy for continued rehabilitation. A licensed Physical Therapist can assess risk factors for reinjury as well as possible underlying causes for the initial injury, itself. A thorough evaluation will be able to identify weakness in the hip, knee and ankle that require rehabilitation, as the active combination of these muscles play a vital role in the entire limb’s stability while walking and moving around. The therapist may additionally be able to identify laxity and/or stiffness in the foot as a result of prolonged time spent in the cast while healing which may require intervention to normalize.
If you are experiencing pain on the outside portion of your foot with increased walking and have noticed slight bruising in the area, it is recommended that you consult with your physician to receive the appropriate care and ask for physical therapy once you are appropriately diagnosed. The physical therapist can either help determine the cause of your pain or help facilitate your recovery, depending on your diagnosis.
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