Abstract
CLINICAL PRESENTATION & EXAM: The Jones Fracture can present to physicians as an ankle sprain and is more common in individuals with high arches. Depending on the severity of the fracture, the patient may experience tenderness to touch, discoloration and swelling, and difficulty walking. During a physical examination, the patient may recall the moment of trauma or pain in the area where the fracture ultimately occurs. A patient will complain of sudden, sharp pain on the outside of the foot during physical activity. ANATOMY & PATHOLOGY: The Jones Fracture is a fracture of the fifth metatarsal, named by Sir Robert Jones in 1902 after he sustained the injury while dancing. There are three zones that dictate the type of injury, blood supply, and treatment. Zone I is a proximal tubercle avulsion experienced during supination and often results in a pull from the lateral band of the plantar fascia. Zone II involves the metaphyseal-diaphyseal junction, including the fourth and fifth metatarsals, and is a result of plantar flexion. Zone III is the proximal diaphyseal fracture caused by stress fractures and repetitive trauma. DIAGNOSTIC TESTING & CONSIDERATIONS: The primary screening tool for a Jones Fracture is the Ottawa Ankle Rules (OARs), which assess bone tenderness at the medial or lateral malleolus, the navicular bone, or the fifth metatarsal, and weight bearing ability. Although widely used, OARs may yield a false-negative test. In such cases, a physical therapist may utilize Rehabilitative Ultrasound Imaging (RUSI) when suspicion remains. Jones Fractures are further classified into three types. Type I, an acute proximal metatarsal fracture without medullary sclerosis; Type II, a delayed union characterized by a widened fracture line and intermedullary sclerosis from prior injury; and Type III, a non-union fracture marked by complete obliteration of the medullary canal due to sclerotic bone, typically associated with repetitive trauma and recurrent symptoms. TREATMENT & RETURN TO ACTIVITY: Treatment of Jones Fractures depends on the severity of the injury. Some fractures are treated using a short-leg walking cast, special orthotic devices, or even rest. However, these treatment plans are often ineffective, can take longer to heal, and in some cases may require seven to twenty months for a full recovery. More invasive treatments, including bone grafting or screws, have been shown to be more effective, with healing occurring in as little as seven weeks. Physical therapy plays a vital role in rehabilitation by focusing on strength recovery through muscle-specific open-chain eccentric and concentric exercises. Patients recovering should engage in non-impact activities, including elliptical training, stationary cycling, and deep-water running.
Recommended Citation
Birnbaum, Chloe; Campbell, Maryn; Spindler, Lindsay; and Ruot, Chuck
(2026)
"Jones Fracture,"
International Journal of Exercise Science: Conference Proceedings: Vol. 2:
Iss.
18, Article 185.
Available at:
https://digitalcommons.wku.edu/ijesab/vol2/iss18/185