Jones Fracture and Lisfranc Fracture: Causes, symptoms and treatment options

Symptoms of a Jones Fracture

Typical symptoms include:

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

Some patients can describe exactly when the injury occurred, while others report an achiness or soreness that has been present for some time. If you experience any of these symptoms, it is important to seek proper medical attention to reduce the risk of a worsening condition.

People at risk for 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

Your doctor 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?

While an avulsion fracture and a Jones fracture are both 5th metatarsal fractures, they are very different types of bone fractures. An avulsion fracture occurs at the base of the fifth metatarsal while a Jones fracture occurs in the middle of the bone.

An avulsion fracture occurs when a small piece of bone attached to a tendon or ligament (this area of bone is called the tuberosity) is pulled from the central part of the bone. In an avulsion fracture, your bone moves one way, and your tendon or ligament moves in the opposite direction with a broken chunk of bone in tow. This most often happens when you suddenly change direction. The condition is also called a dancer’s fracture or pseudo-Jones fracture.

If you feel pain, please consult our offices for X-rays. Avulsion fractures can be severe and require surgery. An X-ray is required 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 occurs has a notoriously poor blood supply. Good blood flow is essential for healing because it brings the necessary nutrients and cells to repair the bone. The limited blood flow to this area can slow down the healing process, leading to a higher risk of non-union (when the bone ends fail to grow back together) or delayed union (when healing takes longer than expected).

The area is also subject to a lot of stress with daily activities, which can make the healing process longer and more complicated. Even with the use of supportive devices like crutches or a walking boot, it can be challenging to fully offload the injured area to allow it to heal. 

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.

It generally takes bones 6-8 weeks to heal. However, the healing of this fracture can take longer than in other areas and can take five months to heal. In some studies, there is as high as a 50% refracture and nonunion rate. The reason for the delayed healing time is due to the area's poor blood supply.

What are the surgical treatment options for a Jones fracture?

In cases where the fracture didn’t properly heal or there are multiple breaks or a displaced bone, surgery may be recommended.

Surgical treatment of a Jones fracture typically allows for a significantly quicker return to activity. Some patients, such as elite athletes, wish to avoid the lengthy natural healing process of a Jones fracture and opt for surgery right away.

During Jones fracture surgery, screw fixation is used for internal fixation to stabilize the fracture. Bone grafting may also be performed to facilitate healing further. 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 (complete healing) of a Jones fracture may take longer than the 6-8 weeks required for most other fractures. Because the area around the fifth metatarsal bone of the foot receives less blood flow, it is prone to injury, and healing time is increased.

What is a Lisfranc Fracture 

When a fracture occurs in the metatarsal and the cuneiform bones (located around the middle foot), it's called a Lisfranc fracture. Lisfranc injuries are often the result of excessive force to the midfoot or a forceful movement when part of the foot is stabilized. An example would 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.

Treatment Options for a Midfoot Lisfanc 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, when the break is in the region of a joint
• Chronic foot pain
• Long-term difficulty walking

If your Lisfranc midfoot fracture has not forced the injured bones out of position, your doctor will cast the area and have you refrain from bearing weight for about six weeks. After the cast is removed, you may have to wear rigid arch support. Foot exercises will help to build strength and restore 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.

You may be interested in visiting our pages discussing broken toes, calcaneal fractures, and broken ankles.

Choose University Foot and Ankle Institute for Your Foot Care

The podiatrists at UFAI are trained trauma specialists and are experts in the treatment of all foot and ankle fractures, including Jones fractures. Our team of physicians is proud to offer state-of-the-art care in a professional, comfortable, and relaxed environment. Our goal is to get you back on your feet and back to normal activity in the shortest amount of time. At-home or in-clinic physical therapy may be recommended following surgery.

Why UFAI is your Best Choice for Foot and Ankle Care

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

Patients are our number one priority. Beginning with the ease of making your appointment, our family-friendly office staff is with you every step of the way. We have our own x-ray, musculoskeletal ultrasound, MRI and 3D CT, at many of our facilities.

We also offer orthotic and brace manufacturing as well as on-site physical therapy services and state-of-the-art operating rooms. This means you will rarely have to go from one specialist to the next, cutting down on your travel needs and wasted time.

While most orthopedic surgeons focus on all the bones and joints in the body, only spending a fraction of their time on the foot and ankle, UFAI's surgeons choose to treat foot and ankle conditions as their lifework.

Podiatric foot and ankle surgeons concentrate exclusively on the foot and ankle from day one of medical school. After medical training, they begin a rigorous three-year surgical residency. What sets podiatric surgical residents apart from general orthopaedic residents is they specialize in the foot and ankle, while most (though not all) ortho residents do not.

Years of training and decades of experience and research is why the foot & ankle surgeons at UFAI have the highest success rates in the United States, literally helping thousands get back on their feet and back to their life.

 

 

 

 

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 to increase blood flow to 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 5th metatarsal fracture?

The timing for resuming running after a 5th metatarsal fracture can vary depending on several factors, including the type of fracture, the treatment received, and how well your bone is healing. 

 

Individuals heals 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, with himself being one of the patients. He sustained a fifth metatarsal fracture after a night of dancing, where he noted aside from a traumatic injury, overloading and applying continued stress along the bone can lead to fracture.

Sources

Rosenberg GA, Sferra JJ. Treatment strategies for acute fractures and nonunions of the proximal fifth metatarsal. J Am Acad Orthop Surg. 2000 Sep-Oct;8(5):332-8. [PubMed]

Torg JS, Balduini FC, Zelko RR, Pavlov H, Peff TC, Das M. Fractures of the base of the fifth metatarsal distal to the tuberosity. Classification and guidelines for non-surgical and surgical management. J Bone Joint Surg Am. 1984 Feb;66(2):209-14. [PubMed]

Chuckpaiwong B, Queen R, Easley M, Nunley J. Distinguishing Jones and Proximal Diaphyseal Fractures of the Fifth Metatarsal. Clin Orthop Relat Res. 2008;466(8):1966-70. doi:10.1007/s11999-008-0222-7

Bernstein DT, Mitchell RJ, McCulloch PC, Harris JD, Varner KE. Treatment of Proximal Fifth Metatarsal Fractures and Refractures With Plantar Plating in Elite Athletes. Foot Ankle Int. 2018 Dec;39(12):1410-1415. [PubMed]

Mulcahey, M. K. (2021). Toe and forefoot fractures. https://orthoinfo.aaos.org/en/diseases--conditions/toe-and-forefoot-fractures