Fractures of the metatarsal bone of the little toe (Os metatarsal V) require special therapy. In order to be able to adapt the therapy precisely, a distinction is first made between various fractures of this bone. The Jones fracture is located in the area of the transition from the metaphysis to the diaphysis.
The fracture does not radiate into the adjacent tarsometatarsal joint V. In this region, blood circulation is restricted and can therefore easily lead to pseudarthrosis. This is especially true if the fracture is caused by chronic overloading. Jones fractures are divided into chronic and acute fractures.
The acute fracture is further divided into undisplaced and dislocated fractures. The chronic fracture is distinguished according to the sclerosis line. The sclerosis line can be located on the outer fracture line or intramedullary and requires different therapeutic approaches.
The avulsion fracture (avulsion fracture), on the other hand, always results from adequate trauma. This is a fracture of a bony prominence of the Os Metatarsale V (tuberosity). The joint space is not affected.
Acute Jones’ fractures without indications of chronic overloading usually heal with a conservative plaster cast. The healing time is between 6 and 12 weeks and allows a pain-adapted full load during the healing phase. The clinical symptoms of the patient are the most important factor in monitoring the progress of the fracture, as the open fracture gap can be shown in the X-ray image for a very long time.
For this reason, the plaster can be removed with painless mobility, even if the fracture is still visible in the imaging image. Chronic Jones fractures are usually accompanied by pain that has been present for a long time. Trauma is usually not required.
Sclerosis around the fracture gap is visible in the X-ray image as a sign of chronic overloading. Since conservative therapy leads to healing, but involves a long healing phase, top athletes in particular should be informed about the long healing phase. If a quick rehabilitation is desired, a screw osteosynthesis or a tension belt can be performed.
Avulsion fractures with simple detachment of the tuberosity can be treated primarily symptomatically. Either by means of an individual insert or with the help of a tape bandage for two to six weeks.
