Jones fracture, also called the 5th metatarsal fracture, is an injury on the diaphysis of the fifth foot metatarsal bone. This bone is found at the base of the small toe, and the fracture occurs at the proximal end, normally at the middle point of the foot. The symptoms of this fracture include pain at the point of injury and swelling, which makes walking difficult.
This fracture has its history from 1902, when it was first described by Sir Robert Jones in his article in the Annals of Surgery. Having sustained the injury himself from dancing, he sought to describe the injury, especially where the cause is indirect impact. The article, which described six patients suffering from the injury, included the classification of the fracture into avulsion, stress and the common Jones fracture.
Diagnosing Jones Fracture
Most cases of this fracture occur without considerable impact. Therefore, most Jones fracture cases easily pass for sprains. When one is suffering from this injury, they experience pain over the area of the fracture, coupled with swelling and difficulty in walking.
In order to ascertain that one really has the fracture and not a sprain, a general diagnostic x ray is essential. This x ray should be taken from all views; oblique, anteroposterior, and lateral. The foot should be in full flection when taking these x rays.
Treating Jones Fracture
A tenuous fracture can easily be corrected using a splint, a cast or a walking boot for one or two months. At this stage, it is highly recommended that one should avoid exerting any pressure or placing any weight on the foot until the doctor allows it. With a success rate of 75 percent, the cast or splint proves quite effective in treating minor cases of the injury.
Acute fractures, however, need specialized treatment methods. Such methods include placing a dynamic compression plate on the strained side of the fracture and using the figure 8 monofilament K wire on the fractured bone.
If the fracture is too acute, it may need to be fixed from the inside. This means that cancellated or cortical screws may be used to join the bones together. Bone grafts may be required to accelerate the healing process. A regular dose of calcium and Vitamin D is also required to hasten the healing of the fracture.
Though a splint or a cast is recommended for minor fractures, surgery is appropriate in certain situations. If an athlete suffers from a Jones fracture, a surgery may be necessary to shorten the extended healing period. However, before opting for surgery, it is best to discuss all the available options with your doctor.
Prospecting Jones Fracture
A metatarsal fracture can fail to unite even after treatment. Though a common occurrence, this failure to unite can cause a chronic condition. If this occurs to you, the first recommendation from your doctor will be an extended time in the cast. This could go up to 20 weeks.
The fracture can fail to heal for several reasons. For starters, the fracture normally occurs at a poor blood supply area. Since the area is a "watershed", it reduces the chances of a successful healing process. In addition, the area of the fracture has numerous tendons. These tendons and muscles may pull the fractured bones apart, which may prolong or prevent healing.
Differentiating Jones Fracture from Other Injuries
Jones fracture is the most severe fracture of the fifth metatarsal bone. There are other fractures of the same bone which are commonly confused with this fracture, though they are less serious. J fractures usually occur on the intermetatarsal joint. However, if the fracture is on the tarsometarsal joint, then it is an avulsion fracture. Avulsion fracture is also called the Pseudo-Jones fracture.
These fractures are also commonly, but wrongly, diagnosed as apophysis, a common adolescent developmental condition. There are several indicators that one is suffering from apophysis and not the fracture. These indicators include absence of fractured edges and the angle of the lucent line. In the fracture, the metatarsal axis is at 90 degrees, while in apophysis, it is parallel.
Jones fractures can be a serious problem depending on how they are handled. Proper diagnosis and early treatment are recommended to ensure the success of the treatment. Enough calcium and vitamin D are also very essential to the healing process. It is also important to know that a Jones fracture can be treated.
No comments:
Post a Comment