Outcome of Early Weight Bearing Cast for the Treatment of Jones Fracture
DOI:
https://doi.org/10.51985/JBUMDC2022153Keywords:
Bone, Bony Callus, Conservative Treatment, Fracture Healing, Metatarsal, Surgical Casts, Weight-BearingAbstract
Objective: To determine the radiological and functional outcome of acute Jones fracture treated conservatively in early
weight bearing cast.
Study Design and Setting: This study was conducted in Orthopaedic Division Lady Reading Hospital Peshawar. The
duration of study extended from 25th August 2018 to 13th November 2022.
Methodology: All patients of both gender and age 18 years and above with isolated Jones fracture fulfilling the inclusion
criteria were treated in below knee early weight bearing cast. Radiological union was assessed by noting callus and
obliteration of fracture line. The functional outcome was determined using American Orthopaedic Foot and Ankle
Score(AOFAS) after cast removal.
Results: This study included a total of 319 patients of Jones fractures who were treated in early weight bearing cast, the
mean age was 34.41±4.29 years. Female patients were 245(76.80%) while male were 74(23.19%). Right foot was involved
in 211(66.14%) patients and left in 108(33.85%). The average union time was 6.2±1.2 weeks. Majority(99.0%,n=316) of
our patients achieved union. Non union was reported in only 3(0.94%) patients. Excellent functional outcome was
documented in our patients as indicated by mean AOFAS score 99.1±1.1. Comparison of AOFAS score for gender, side
and type of fracture did not reveal any significant difference.(p>0.05)
Conclusion: Early weight bearing cast is an effective modality of conservatively treating acute Jones fractures as shown
by higher union rate and excellent functional outcome in majority of our patients
References
Jones R. I. Fracture of the Base of the Fifth Metatarsal Bone
by Indirect Violence. Ann Surg. 1902;35(6):697-700.
Lawrence SJ, Botte MJ. Jones’ fractures and related fractures
of the proximal fifth metatarsal. Foot Ankle Int 1993;14(6)
:358–65. DOI: 10.1177/107110079301400610
Coleman MM, Guyton GP. Jones Fracture in the Nonathletic
Population. Foot Ankle Clin. 2020;25(4):737-751. DOI:
1016/j.fcl.2020.08.012.
Smith JW, Arnoczky SP, Hersh A. The intraosseous blood
supply of the fifth metatarsal: implications for proximal
fracture healing. Foot Ankle 1992; 13(3):143–52. DOI: 10.1177
/107110079201300306
Herterich V, Baumbach SF, Kaiser A, Bocker W, Polzer
H.Fifth metatarsal fracture-a systematic review of the treatment
of fractures of the base of the fifth metatarsal bone. Dtsch
Arztebl Int 2021; 118: 587–94. DOI: 10.3238/arztebl. m2021
.0231.
Chloros GD, Kakos CD, Tastsidis IK, Giannoudis VP, Panteli
M, Giannoudis PV. Fifth metatarsal fractures: an update on
management, complications, and outcomes. EFORT Open
Rev. 2022;7(1):13-25.DOI: 10.1530/EOR-21-0025.
Albloushi M, Alshanqiti A, Qasem M, Abitbol A, Gregory T.
Jones type fifth metatarsal fracture fixation in athletes: A
review and current concept. World J Orthop. 2021;12(9):640-
DOI: 10.5312/wjo.v12.i9.640.
Choi YR, Kim BS, Kim YM, Park JY, Cho JH, Kim S, Kim
HN. Hard-Soled Shoe Versus Short Leg Cast for a Fifth
Metatarsal Base Avulsion Fracture: A Multicenter,
Noninferiority, Randomized Controlled Trial. J Bone Joint
Surg Am. 2021;103(1):23-29. DOI: 10.2106/JBJS.20.00777.
Marecek GS, Earhart JS, Croom WP, Merk BR. Treatment
of Acute Jones Fractures Without Weight bearing Restriction.
J Foot Ankle Surg. 2016;55(5):961-4.DOI : 10.1053/j.jfas.
04.013.
Sung KS, Koh KH, Koo KH, Park JC. Conservative treatment
of nondisplaced fifth metatarsal base zone I and II fractures.
J Korean Foot Ankle Soc.2008;12(2):185–188.
Naing L, Winn T, Rusli BN. Practical Issues in Calculating
the Sample Size for Prevalence Studies. Archives of Orofacial
Sciences 2006; 1: 9-14.
Ceccarelli F, Calderazzi F, Pedrazzi G. Is there a relation
between AOFAS ankle-hindfoot score and SF-36 in evaluation
of Achilles ruptures treated by percutaneous technique? J
Foot Ankle Surg. 2014;53(1):16-21. DOI: 10.1053/j.jfas.
09.005.
Chuckpaiwong B, Queen RM, Easley ME, Nunley JA.
Distinguishing Jones and proximal diaphyseal fractures of
the fifth metatarsal. Clin Orthop Relat Res. 2008;466(8):1966-
DOI: 10.1007/s11999-008-0222-7.
Monteban P, van den Berg J, van Hees J, Nijs S, Hoekstra H.
The outcome of proximal fifth metatarsal fractures: redefining
treatment strategies. Eur J Trauma Emerg Surg. 2018;44(5):
-734. DOI: 10.1007/s00068-017-0863-x.
Choi YN, Choi YR, Seo JH, Lee HS, Kim SW, Jeong JJ.
Results of non-operative treatment of the zone I, II fifth
metatarsal base fracture. J Korean Foot ankle Soc.2011;
(4):207-2011.
Biz C, Zamperetti M, Gasparella A, Dalmau-Pastor M,
Corradin M, de Guttry G, et al. Early radiographic and clinical
outcomes of minimally displaced proximal fifth metatarsal
fractures: cast vs functional bandage. Muscles Ligaments
Tendons J. 2018;7(3):532-540. DOI: 10.11138/mltj/ 2017.
3.532.
Baumbach SF, Prall WC, Kramer M, Braunstein M, Bocker
W, Polzer H. Functional treatment for fractures to the base
of the 5th metatarsal - influence of fracture location and
fracture characteristics. BMC Musculoskelet Disord.
;18(1):534. DOI: 10.1186/s12891-017-1893-6.
Konkel KF, Menger AG, Retzlaff SA. Nonoperative treatment
of fifth metatarsal fractures in an orthopaedic suburban private
multispeciality practice. Foot Ankle Int. 2005;26(9):704-7.
DOI: 10.1177/107110070502600907.
Look N, Reisenauer CR, Gorman MA. Conservative
management of Jones fractures with immediate weight-bearing
in a walking boot demonstrates healing. Foot (Edinb).
;50:101870. DOI: 10.1016/j.foot.2021.101870.
Bernardino S. Non randomised retrospective study of jones
fractures treated by conservative treatment. Phys Med Rehabil
Res. 2019.DOI: 10.15761/PMRR.1000193
Park JY, Kim HN, Hyun YS, Park JS, Kwon HJ, Kang SH,
et al. Effect of Weight-Bearing in Conservative and Operative
Management of Fractures of the Base of the Fifth Metatarsal
Bone. Biomed Res Int. 2017:1397252.DOI: 10.1155/2017/
Rikken QGH, Dahmen J, Hagemeijer NC, Sierevelt IN,
Kerkhoffs GMMJ, DiGiovanni CW. Adequate union rates for
the treatment of acute proximal fifth metatarsal fractures.
Knee Surg Sports Traumatol Arthrosc. 2021;29(4):1284-
D OI: 10.1007/s00167-020-06072-8.
Baumbach SF, Urresti-Gundlach M, Bocker W, Vosseller JT,
Polzer H. Results of Functional Treatment of Epi-Metaphyseal
Fractures of the Base of the Fifth Metatarsal. Foot Ankle Int.
;41(6):666-673. DOI: 10.1177/1071100720907391.
Vorlat P, Achtergael W, Haentjens P. Predictors of outcome
of non-displaced fractures of the base of the fifth metatarsal.
Int Orthop. 2007;31(1):5-10. DOI: 10.1007/s00264-006-0116-
Ruta DJ, Parker D. Jones Fracture Management in Athletes.
Orthop Clin North Am. 2020;51(4):541-553. DOI: 10.1016/
j.ocl.2020.06.010.
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Copyright (c) 2023 Faaiz Ali Shah, Mian Amjad Ali, Naeemullah Dawar`, Mian Javed Iqbal
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