• Annie Bellitti, PT, DPT

FOOT PAIN? YOU MIGHT HAVE A FRACTURE


Are you experiencing pain and swelling on the outside of your foot? Are you having difficulty walking? You may have a stress fracture, commonly known as Jones Fracture. This is a repetitive stress type injury commonly seen with runners.

A Jones Fracture is a stress fracture of the 5th Metatarsal at the metaphyseal-diaphyseal junction. They are often the result of repetitive stress built up over time. These fractures can be slow to heal. There is a high incidence of non-union due to poor blood supply in this area. This is different from an avulsion fracture (Dancer’s Fracture) where the insertion of the Peroneus Brevis pulls the bone or a fracture of the distal metatarsal.

Mechanism of Injury:

This is an overuse, repetitive stress type of injury. Injury occurs with a repetitive load applied under the metatarsal head over a relatively short time such as in running.

Contributing Factors:

  • High arch

  • Increased loading of the lateral foot possibly due to alignment of the lower extremity

Symptoms:

  • Pain and swelling in the lateral foot

  • Difficulty walking

Treatment is Variable:

Bony callus formation is visable on x-ray at 6-8 weeks post-injury. However, 1/3 of all Jones fractures end in non-union. Treatment options are as follows:

  • Weight Bearing in a Cast/Boot: 6-8 weeks in a cast or boot but able to put weight on it

  • Non-weight Bearing: 6-8 weeks in a cast or boot without putting weight through the foot. 14-15 weeks ‘til return to activities

  • Operative: Shorter times to union and quicker return to sport. This is typical of the younger and athletic population. 4-6 weeks non-weight bearing with a return to sport around 8 weeks. This is also the choice if non-operative treatment fails or the fracture is displaced.

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