![]() ![]() ![]() usually present between the ages of 9 to 14 years ![]() this is the most common frx of the base of the 5th metatarsal hence, strictly speaking a Jones frx is an acute injury in addition, the acute Jones frx must be distinguished from the chronic Jones frx the later of which may represent a stress frx w/ poor prognosis for healing this fracture is usually proximal to the metatarsal cuboid joint Jones frx is located w/in 1.5 cm distal to tuberosity of 5th metatarsal & should not be confused w/ more common avulsion frx of 5 th metatarsal styloid It is important not to overlook other associated injuries to ligaments of the ankle and foot.- involves frx at base of fifth metatarsal at metaphyseal-diaphyseal junction, which typically extends into the 4-5 intermetatarsal facet In these cases, the bone fragments are repositioned and stabilized with screws and/or a plate. Surgery may be needed when there is complete displacement of the fracture fragments or failure to heal with non-operative treatment after several months. It can be many months before the bone is completely healed and a full recovery has been achieved. They can usually resume dance activities by 10-12 weeks and return to performance level by 19 weeks. Patients are often still symptomatic 6 to 8 weeks or more after this injury. This is a frustrating injury because it takes a long time for healing to occur. Usually by 6 weeks, there is enough healing to allow them to transition to a stiff-soled shoe with lots of padding. As the swelling settles and the fracture starts to heal, they can begin walking more extensively in the boot. Although weight bearing is allowed, for the first few weeks, they will have to significantly limit their walking and may need crutches due to pain and discomfort. Typically, patients are placed in a walking boot. Treatment involves relative rest and time to allow the fracture to heal. The fracture has a very high rate of healing with non-operative treatment. Figure 3A: X-ray from the side (Lateral View)Ī 5th metatarsal shaft “Dancer’s” fracture is an injury that is usually treated non-operatively. There will be gapping at the fracture and there may be some shortening or rotation of the fracture (Figures 3A-3B). The usual fracture pattern is a spiral running from the outside aspect of the bone (distal lateral) near the toes to the inside aspect of the bone near the ankle (proximal medial). The size of the fractured fragment may vary considerably. X-rays of the foot will reveal a long oblique fracture of the shaft of the 5th metatarsal. However, the main tenderness will usually be just before the base of the fifth toe. There may be tenderness and swelling over a large area of the outside of the foot. When pressing on the outside of the foot, there will be marked tenderness over the 5th metatarsal. Figure 2: Twisting mechanism causing injury It will be associated with quite specific local tenderness over the bone near the base of the fifth toe and on the outside of the foot (the 5th metatarsal). Over time, the skin can turn black and blue. Weight bearing on the injured foot may be difficult due to pain and discomfort. It can be associated with significant swelling. This will produce immediate pain over the outside aspect of the foot near the toes. An acute rolling of their ankle while pointing the toes down can also fracture the shaft of the 5th metatarsal (See Figure 1). Figure 1: 5th Metatarsal Shaft “Dancer’s” FractureĪ patient who suffers a 5 th shaft fracture (See Figure 1) commonly gives a history of a twisting injury to their ankle and foot (inversion and plantarflexion injury), similar to what occurs with an ankle sprain (Figure 2). However, since this fracture of the fifth metatarsal was first described in ballet dancer’s, it has become known as a dancer’s fracture as well. **There is another fracture that may also be referred to as a dancer’s fracture. It often takes 4 or more months for a full recovery to occur. It typically takes about 6 weeks for adequate bone healing to occur, before patients can start to significantly increase their activity level. In many instances, this type of fracture can be treated non-operatively, with relative immobilization in a walking boot combined with limited weight-bearing. This 5th metatarsal “Dancer’s” fracture causes localized pain, swelling, and difficulty walking. During this injury, the 5th metatarsal is twisted by a strong force resulting in a spiral fracture. A twisting injury to the ankle and foot may cause a long fracture of the 5th metatarsal shaft - the bone that attaches the little toe to the midfoot (Figure 1). ![]()
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