Fifth Metatarsal Fracture (Jones Fracture)

A Jones fracture occurs in the fifth metatarsal — the long bone on the outside of the foot that connects to the little toe. This area receives less blood than other regions of the foot, which can make healing difficult. Typically, this type of fracture results from stress on the bone caused by repeated motion, but it may also result from overuse or a sudden acute injury.

Two types of fractures that often occur in the fifth metatarsal are:

  • Avulsion fracture. In an avulsion fracture, a small piece of bone is pulled off the main portion of the bone by a tendon or ligament. This type of fracture is the result of an injury in which the ankle rolls. Avulsion fractures are often overlooked when they occur with an ankle sprain.
  • Jones fracture. Jones fractures occur in a small area of the fifth metatarsal that receives less blood and is, therefore, more prone to difficulties in healing. A Jones fracture can be either a stress fracture (a tiny hairline break that occurs over time) or an acute (sudden) break. Jones fractures are caused by overuse, repetitive stress or trauma. They are less common and more difficult to treat than avulsion fractures. Other types of fractures can occur in the fifth metatarsal. Examples include midshaft fractures, which usually result from trauma or twisting, and fractures of the metatarsal head and neck.

Causes

Fractures of the fifth metatarsal are caused by overuse and repetitive stress or trauma. Overuse and stress result in a hairline fracture that develops over time. This can be caused merely by walking, jumping, or running, and is often more noticeable in a patient with a high arch. Sudden trauma to the foot, such as a turned ankle or another inward twisting of the foot, can also cause this fracture. Professional athletes are frequently affected.

Symptoms

Avulsion and Jones fractures have the same signs and symptoms.

Contact your doctor if you notice:

  • Pain, swelling, and tenderness on the outside of the foot
  • Difficulty walking
  • Bruising

Potential Treatments

If you have symptoms resulting from a fifth metatarsal fracture, you should contact your doctor as soon as possible for proper diagnosis and treatment. To arrive at a diagnosis, you may be asked how the injury occurred or when the pain started. To examine your condition, your doctor will gently press on different areas of the foot to determine if and where there is pain. X-rays may also be performed. Because this fracture sometimes does not show up on initial x-rays, additional imaging studies may be needed.

If the injury involves a displaced bone, multiple breaks, or has failed to adequately heal, surgery may be required. Your doctor will determine the type of procedure that is best suited for you.

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