Jones fracture of the fifth metatarsal: Is operative intervention justified? A systematic review of the literature and meta-analysis of results

Foot (Edinb). 2015 Dec;25(4):251-7. doi: 10.1016/j.foot.2015.08.001. Epub 2015 Aug 11.

Abstract

Background: This study assesses the outcomes of surgical vs. conservative management in the treatment of the Jones fracture.

Materials and methods: A systematic review using four databases from their inception until September 2014 was undertaken. Six studies were found evaluating operative therapy compared to conservative treatment.

Results: Six relevant studies were included, with a total of 237 patients. Of these, 51% were treated non-operatively, and 49% had surgical intervention. Those in the non-operative group were found to have a significantly higher odds ratio (OR) of fracture non-union (OR 5.74, 95% confidence interval (CI) 2.65-12.40, P<0.001). Studies also reported a prolonged healing time and a longer time to return to sports. Of the trials with time to union as an outcome measure, 3 of 4 trials found favourable results in the operative cohort.

Conclusions: Surgical intervention is recommended for patients presenting with a Jones fracture as it is found to result in a lesser non-union rate and an improved time to union.

Keywords: Conservative; Jones fracture; Management; Nonunion; Surgical; Time to union.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Athletic Injuries / surgery*
  • Fracture Fixation, Internal / methods*
  • Fracture Healing
  • Fractures, Stress / surgery*
  • Humans
  • Metatarsal Bones / injuries
  • Metatarsal Bones / surgery*