FRACTURES OF THE FIFTH METATARSAL BASE – JONES.pptx

Fracture of 5th metatarsal - Jones fracture

1. Dr.Akshay FRACTURES OF THE FIFTH METATARSAL BASE – JONES FRACTURE

2. introduction The fifth metatarsal base extends much more proximal into the midfoot region, compared to the other metatarsal bases. It articulates with the cuboid and with the fourth metatarsal. The peroneus brevis tendon and lateral band of the plantar fascia insert onto the base of the fifth metatarsal. There is a relative watershed in the blood supply to the fifth metatarsal at the junction between the diaphysis and metaphysis.

3. Clinical Features Forced inversion of the foot (the ‘pot-hole injury’) may cause avulsion of the base of the fifth metatarsal, with pull-off by the peroneus brevis tendon or the lateral band of the plantar fascia. Pain due to a sprained ankle may overshadow pain in the foot. Examination will disclose a point of tenderness directly over the prominence at the base of the fifth metatarsal bone.

4. Diagnosis X-ray Occasionally a normal peroneal ossicle in this area may be mistaken for a fracture; there is also an apophyseal ossification centre in the tuberosity .

5. Treatment The proximal avulsion fractures can usually be treated symptomatically, with initial rest and support, but with early mobilization and return to function. The intra-articular injuries and those at the metaphyseal–diaphyseal junction may also be treated nonoperatively , but there is a greater risk of non-union and slower return to function. The role of fixation with an inter-fragmentary screw or screws and plate is therefore an issue for discussion between the surgeon and the patient, depending to a large extent on the patient’s functional demands and expectations with respect to sport, activity, and time away from these.

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