If you have a look at the bones in the foot, you will find that the fifth metatarsal is the bone present at the base of the foot. A fracture at the proximal end of the foot, in the fifth metatarsal is called Jones fracture. This is a very painful and causes a lot of swelling and walking difficulty.
If you are wondering, why it is called so, then allow me to explain. This fracture was first described in 1902 by Sir Robert Jones. He had mentioned this injury in an article, 'Fractures of the Base of the First Metatarsal Bone by Indirect Violence.' In this article, he described the features of fractures occurring in this particular area of the foot.
This fracture occurs in a very small area of the fifth metatarsal of the foot bone. This area receives less blood supply. Therefore, it takes a long time for the injury to heal. It can either be a stress fracture or an acute fracture. The former is the one that occurs as a tiny break over time. The latter is the one that breaks suddenly. Symptoms are as follows -
- Moderate to severe pain on the outer edge of the foot
- Swelling and tenderness of the foot
- Walking difficulty
- Bruising in some cases
It occurs due to inward twisting of the foot. These inversion injuries occur due to overuse of the foot, repetitive stress on the bones or a sudden trauma.
If one suffers from an injury to the fifth metatarsal, they need medical attention right away. This will help prevent any complications and curb further damage. The doctor will conduct an X-ray which will help prove what kind of a fracture it is. It will also help to diagnose other complications present like avulsion fracture.
The first thing to do when one suffers from a Jones fracture is to follow the R.I.C.E method. This means, one needs to immediately Rest the foot. Do not try to walk as you may cause further damage to the foot. Next, application of Ice compress for about 20 minutes should be done. After application of ice, you need to Compress the foot with an elastic wrap. This will help in controlling the swelling. And lastly, Elevation of the injured foot slightly above the heart level will keep the swelling in check.
As soon as you can, visit the doctor for further treatment. Depending on the severity of the fracture, he will place the foot in a cast, stiff-soled shoe or a cast boot. This cast is placed on the foot for about 4 to 8 weeks. As one is not supposed to place any weight on the foot, the doctor will suggest walking with the aid of crutches. About 3/4th fractures heal completely with this treatment. Patients are also recommended non-steroidal anti-inflammatory drugs that help in reduction of the pain and swelling.
A surgery is performed only if the fracture does not heal properly or the condition becomes chronic. The doctor recommends fluoroscopy procedure to be conducted. Here, a K wire that is shaped as 'number 8' is inserted into the foot. This helps in determining the position and length of the bone. Then, the area around the fracture is cleaned, bone is repositioned and pinned with screws, if necessary. A cast will be placed to protect the bone during the healing process.
If the fracture still fails to heal, the patient is required to wear the cast for 20 weeks more. In some cases, it becomes a chronic condition. As mentioned earlier, the lack of adequate blood supply delays the healing process. The muscles and tendons around the fracture tear and pull the bones further apart. This delays healing.
It is a very rare injury. However, it is also one of the injuries that is very difficult to treat. Make sure you seek medical advice on time and follow all the treatment guidelines given by the doctor for quick healing of this bone fracture at the base of foot.