Jones fracture

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A Jones fracture is the break between the base and the middle portion of the fifth leg metatarsal. This produces pain near the center of the foot on the outside. There may also be bruising and difficulty walking. Onset is generally abrupt.

This fracture usually occurs when the toes point and the legs bend inward. This movement can occur when changing direction when the heel is detached from the ground such as dancing, tennis, or basketball. Diagnosis is generally suspected based on symptoms and confirmed by X-rays.

Initial care is usually in a cast, without walking on it, for at least six weeks. If after the healing period does not occur six weeks further than the foundry may be recommended. Due to the poor blood supply in this area, the rest sometimes does not heal and surgery is required. In athletes or if bone fragments are separated surgery can be considered faster. This fracture was first described in 1902 by orthopedic surgeon Robert Jones who suffered an injury while dancing.

Video Jones fracture

Diagnosis

A person with a Jones fracture may not be aware that a fracture has occurred. Diagnosis includes palpation of intact peroneus brevis tendon, and demonstration of distal localized tenderness to the fifth metatarsal tuberosity, and localized over diaphisis proximal metatarsal. Unusual bone crepitus.

This injury should be distinguished from developmental apophysis (metatarsal tuberosity 5) generally and usually occurs on this site in adolescents. Differentiation is possible by characteristics such as the absence of sclerosis from the crack edges (in the acute case) and the orientation of the lucent line: transverse (at 90 degrees) to the metatarsal axis for fracture (due to the pull of the avulsion by peroneus brevis muscle inserting at the proximal end) - and parallel to the axis metatarsal in case of apophysis. Diagnostic x-rays include anteroposterior, oblique, and lateral views and should be made with the foot in full flexion.

Differential diagnosis

Another proximal fifth metatarsal fracture exists, though this fracture is not as severe as Jones. If a fracture enters an intermetatarsal joint, it is a Jones fracture. However, if it enters the tarsometatarsal joint, then it is an avulse fracture caused by the pull of the peroneus brevis. Avulsion fractures are sometimes called Pseudo-Jones fractures or Dancer fractures.

Maps Jones fracture

Treatment

Casting

Initial treatment is usually in a cast, no weight placed on it, at least for six weeks. If after the healing period does not occur six weeks further than the foundry may be recommended. Up to half, but may not recover after casting.

Surgery

In athletes or if bone fragments separated by more than 2 mm of operation may be considered. Otherwise surgery is recommended if healing does not occur after 12 weeks of casting.

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Prognosis

For some reason, the Jones fracture may not be united. Diaphyseal bone (zone II), where fracture occurs, is a potentially bad area of ​​blood supply, which is in the watershed between two blood supply. This may endanger healing. In addition, there are various tendons, including peroneus brevis and fibularis tertius, and two small muscles attached to the bone. It can pull apart fractures and prevent healing.

Zones I and III have been linked to relatively secure unions and this union has occurred only with limited activity restrictions combined with early immobilization. On the other hand, zone II has been associated with either delayed or non-union and, consequently, it has been generally agreed that fractures in this area should be considered for some form of internal immobilization, such as internal screw fixation.

This zone can be identified anatomically and on x-rays adds to the clinical utility of this classification. It should be emphasized that surgical intervention is not, by itself, a guarantee of healing and has its own degree of complications. Other reviews of the literature have concluded that conservative, non-operative treatment, is an acceptable option for non-athletes.

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References

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External links

Business

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Source of the article : Wikipedia