Jones Fracture and Lisfranc Fracture

What is a Jones fracture?

A Jones fracture is a break at the base of the fifth metatarsal bone, which is the long bone on the outside of the foot leading to the pinky toe. This common foot injury frequently affects both elite athletes and weekend warriors.

This area has poor blood supply, making healing difficult. Since a Jones fracture is very similar to a sprain or avulsion fracture (known as a “pseudo-jones” injury), it is essential to be examined by an experienced orthopedic sports medicine foot and ankle specialist.

What are the symptoms of a Jones fracture?

Typical symptoms include:

• Pain or achiness on the outside of your foot
• Swelling and/or bruising in the injured area
• Walking with a limp or unable to bear weight

Some patients can pinpoint exactly when the injury happened, while others describe a dull ache or soreness that has persisted for a while. If you experience any of these symptoms, it is important to seek appropriate medical care to lower the risk of your condition worsening.

People at risk for a Jones fracture include:

• Elite athletes, weekend warriors, and those with a sudden increase in high-impact activity
• Dancers
• Employees who walk or stand most of the time
• Patients with osteoporosis

Dr. Bob will examine the foot and discuss how long you have been experiencing pain and how the injury occurred. X-rays most likely will be ordered. In some cases, fifth metatarsal fractures do not show on initial X-rays, and additional imaging may be necessary.

What’s the difference between an avulsion fracture and a Jones fracture?

Although both an avulsion fracture and a Jones fracture are types of fifth metatarsal fractures, they are distinct. An avulsion fracture happens at the base of the fifth metatarsal, whereas a Jones fracture occurs in the middle of the bone.

An avulsion fracture happens when a small piece of bone attached to a tendon or ligament (called the tuberosity) is pulled away from the main part of the bone. In this type of fracture, your bone moves in one direction, while your tendon or ligament moves in the opposite direction, bringing a broken piece of bone with it.

This usually occurs when you suddenly change direction. The condition is also known as a dancer’s fracture or pseudo-Jones fracture.

If you feel pain, please consult Dr. Bob Baravarian’s office for X-rays. Avulsion fractures can be severe and require surgery. An X-ray is necessary to differentiate a fracture from a sprain.

Avulsion fractures without surgery usually take about 3-12 weeks to heal completely.

Why are Jones fractures challenging to treat?

The area where a Jones fracture happens has a notoriously poor blood supply. Good blood flow is crucial for healing because it supplies the necessary nutrients and cells to mend the bone. 

The limited blood flow to this area can slow the healing process, increasing the risk of non-union (when the bone ends fail to grow back together) or delayed union (when healing takes longer than expected).

The area also experiences a lot of stress from daily activities, which can prolong and complicate the healing process. Even using supportive devices like crutches or a walking boot, it can be difficult to offload the injured area enough for it to heal properly. 

What are the Jones fracture treatment options?

Non-surgical treatment will be recommended and may include:

• Non-weight bearing: Keep the weight off the foot; crutches are used in most Jones fracture cases
• Immobilization: a walking boot/splint or hard-soled shoe to protect the fracture site and keep it immobile to avoid re-fracture and better bone healing.
• Anti-inflammatory medication: to reduce swelling and pain from this broken bone.
• Ice pack: Icing the injured foot for 15- 20 minutes, several times per day.

Bones typically take 6-8 weeks to heal. However, healing this fracture can take longer, often around five months. Some studies report up to a 50% rate of refracture and nonunion. The delayed healing is due to the area’s poor blood supply.

What are the surgical treatment options for a Jones fracture?

In cases where the fracture doesn’t heal correctly, has multiple breaks, or involves a displaced bone, surgery might be recommended.

Surgical treatment of a Jones fracture usually enables a much faster return to activity. Some patients, like elite athletes, prefer to avoid the lengthy natural healing process of a Jones fracture and choose surgery immediately.

During Jones fracture surgery, screw fixation is used for internal stabilization of the fracture. Bone grafting may also be performed to promote healing. Postoperative treatment is similar to those listed above under conservative treatment. 

Metatarsal fracture surgery generally involves a 6 to 8-week recovery period in a walking cast/boot, and you’ll likely need to follow-up X-rays to make sure your bones are healing correctly.

What is Jones fracture recovery?

The recovery time for a Jones fracture, which is the complete healing process, may take longer than the 6-8 weeks typical for most other fractures. Since the area around the fifth metatarsal bone in the foot receives less blood flow, it is more susceptible to injury, and the healing process takes longer.

What is a Lisfranc fracture?

When a fracture occurs in the metatarsal and cuneiform bones (located around the middle of the foot), it’s called a Lisfranc fracture. Lisfranc injuries often result from excessive force to the midfoot or a forceful movement when part of the foot is stabilized. An example might be an injury to the foot while horseback riding, with the front part of the foot locked into the stirrup.

Other midfoot fracture causes are related to traffic collisions, a fall from a significant height, or a heavy object falling onto the foot. Lisfranc fractures are rare, and the type of fracture is often missed on initial X-rays.

What are treatment options for a midfoot Lisfranc fracture?

Proper treatment of Lisfranc injuries is critical. Complications of an untreated midfoot fracture include:

• Permanent mal-alignment of the bone, resulting in limited ability to walk on the foot or fit into shoes
• Arthritis occurs when there is a break in the region of a joint
• Chronic foot pain
• Long-term difficulty walking

If your Lisfranc midfoot fracture hasn’t displaced the bones, your doctor will put a cast on the area and advise you to avoid bearing weight for about six weeks. After removing the cast, you might need to wear a rigid arch support. Foot exercises will help to build strength and regain a full range of motion.

Surgery is often required to stabilize the bones until healing is complete. Post-surgery, you will have to wear a cast and limit weight-bearing for as long as eight weeks. You may wear a walking brace while transitioning to a normal shoe.

Why Dr. Baravarian is your best choice for Jones fracture and treatment in Los Angeles

Dr. Bob is a trained trauma specialist and is an expert in the treatment of all foot and ankle fractures, including Jones and Lisfranc fractures. He is proud to offer state-of-the-art care in a professional, comfortable, and relaxed environment. His goal is to get you back on your feet and back to normal activity as soon as possible. At-home or in-clinic physical therapy may be recommended following surgery.

Using the most advanced techniques, some of which Dr. Bob helped develop, has allowed him to maintain the highest success rates in the nation for ankle injuries. His goal is to quickly get you back on your feet, utilizing the least invasive treatments possible.

While most podiatric surgeons focus on all the bones and joints in the body, dedicating only a small part of their time to the foot and ankle, Dr. Bob chooses to specialize in treating foot and ankle conditions as his lifelong career.

Years of training and decades of experience and research are why Dr. Bob has among the highest success rates in the United States, literally helping thousands get back on their feet and back to their life.

Dr. Bob Baravarian is conveniently located in Los Angeles, near Cedars-Sinai Medical Center, providing expert foot and ankle care for patients throughout Southern California.

Jones fracture FAQs

What foods help broken bones heal faster?

While there is no magic food that can miraculously mend a broken bone overnight, a balanced diet rich in certain nutrients can support the healing process. This includes food rich in calcium, vitamin D, protein, vitamin C, vitamin K, omega-3 fatty acids, magnesium, and zinc.

How can you increase blood flow to a Jones fracture?

Increasing blood flow to a Jones fracture can be important for the healing process, as adequate blood supply is crucial for delivering nutrients and oxygen to the injured area. Here are some general tips that may help:

• Rest and Immobilization
• Elevation
• Ice
• Compression
• Physical Therapy
• Nutrition: A balanced diet rich in nutrients can support the healing process and improve blood circulation.
• Smoking Cessation
• Medications: Your doctor may prescribe medications to manage pain and inflammation, which can indirectly support blood flow by reducing discomfort.

How soon can I run after a 5th metatarsal fracture?

The timing for starting to run again after a 5th metatarsal fracture varies based on several factors, including the type of fracture, the treatment received, and the rate of bone healing.

Individuals heal at their own pace, and it’s essential to prioritize the healing process over the desire to return to running quickly. Rushing back into high-impact activities too soon can lead to reinjury or delayed healing.

How did Jones Fracture get its name?

The name Jones fracture is derived from Sir Robert Jones, who wrote about the fracture in Annals of Surgery in 1902. He discussed the findings of the fracture in 6 patients, including himself. He sustained a fifth metatarsal fracture after a night of dancing, where he noted that, aside from a traumatic injury, overloading and applying continued stress along the bone can lead to fracture.