Jones Fractures

[karen.hankey]

I'm after some advice for a 19 year old semi-pro footballer with a Jones fracture.

He actually injured it in approx November 06, the club doctor at the time told him uit wasn't fractured, so he carried on as normal. When still painful he sought medical advice and a fracture was found. He had surgery to insert a plate I think and then in plaster for approx 6 weeks and told not to do anything. Following removal of the plaster he began rehab. I was concerned when I heard he was running but it was still painful - club doctor told him this was normal. Now I understand that it would be sore due to doing activity again, but sharp paion over the fracture site surely isn't correct is it?

The big shock came when he played a competative match at the weekend for about 40 mins, even though he still gets pain whil running and is doing so with an obvious limp. Following this he saw his consultant on tues and has been told there is non-union and they will have to insert a screw.

Any advice appreciated so this poor young lad doesn't have to suffer anymore than necessary.

I would get him doing some CV exercise using a bike, but instead of his feet to pedal use his hands, to try and maintain fitness. Also have read that dorsiflexion and inversion against theraband is ok initially to decrease muscle atrophy - is this true?

[alophysio]

Very difficult to say what needs to happen without seeing the guy. Understand your concerns though.

I would personally liase directly with his orthopaedic surgeon as to what he can and can't do. Usually the # is stable because of the plate and screw but can't be certain. If it is stable, you would think that weight bearing within tolerances is important for bone laydown. Making sure he stays out of pain is also important in a lot of ways - don't want CRPS!

Otherwise, as noted above, liase directly with the orthopod via phone or in person if possible to ensure exact rehab conditions.

Good luck!

[wutti]

hi i agree in total with alophysio. If a screw will implanted the fracture should be stable, but concerning to the history of that young guy you should be careful with weight bearing. water gymnastics and under water jogging seems to be an option for CV fitness. also all other strenghtening of quats, hams gluts etc. is ok. also keep flexibility of muscle around ankle knee and hip joint. usually a fracture needs about 6 weeks to be stable enough for full weight bearing, but talk to the orthop.
and keep this guy motivated!!!
cheers

[physiobob]

Firstly some definitions for you all. More on treatment etc soon:

Definition: A Jones fracture is an injury to the fifth metatarsal bone of the foot. The fifth metatarsal bone is at the base of the small toe, and the Jones fracture occurs in the midfoot area (the top of the bone).

Why is this called a "Jones Fracture"?

This injury was first described in 1902 by Sir Robert Jones in an article titled "Fractures of the Base of the First Metatarsal Bone by Indirect Violence." He included descriptions of six patients (one being himself) who sustained fractures in this area without a direct impact (his injury occurred while dancing). This article included fractures we now classify as avulsion fractures, stress fractures, and what we presently refer to as a Jones fracture.

What are the symptoms of a Jones fracture?

Patients who sustain a Jones fracture have pain over this middle/outside area of their foot, swelling, and difficulty walking. Most often a Jones fracture is caused without significant injury or impact.