A Jones fracture, named for the doctor who first described it, is an injury to the fifth metatarsal bone of the foot, the bone at the base of the small toe. This fracture most often occurs as the result of an ankle sprain or other foot injuries where the foot turns inward (inversion injury), and not as a result of direct impact to the area. Repetitive stress may also cause a Jones fracture.
Because there is a limited blood supply in the area, and because a Jones fracture further interrupts blood flow, such a fracture may take longer to heal than other injuries. There is a possibility that there may be a non-union, or failure of the bone to heal, requiring surgical intervention.
Symptoms Of A Jones Fracture
Patients with a Jones fracture typically experience pain on the middle and outside of their foot, along with swelling, bruising and difficulty walking. Because a Jones fracture frequently occurs in conjunction with another injury, it may go undetected. Because it may have difficulty healing, it is important that a correct diagnosis be made promptly.
Symptoms Of A Jones Fracture
Mild Jones fractures are normally immobilized with a cast, splint or walking boot for 6 to 8 weeks. Usually, patients use crutches to keep the injured foot from bearing any weight. Patients are given non-steroidal anti-inflammatory drugs (NSAIDS) to reduce pain and swelling. Once the cast is removed, patients require an additional 2 to 3 weeks of rehabilitation. As with other fractures, older patients usually take longer to heal than younger patients.
In more severe cases, where the bone is displaced by the fracture or does not heal properly, surgery is necessary to treat the fracture. Surgery is also frequently performed on professional athletes to shorten the healing process. Metal devices, such as plates or screws,are used in such operations to fixate the bone. Sometimes a bone graft or a substance that will stimulate bone growth is also used. After surgery, the foot is put in a cast to immobilize it and protect it during the healing process.
A toe fracture, though very painful, is not usually a serious injury. Nonetheless, it must be appropriately treated to ensure proper healing. In most cases, a toe fracture, particularly of one of the small toes, can be treated nonsurgically, frequently by home remedies. At times, however, if the fracture is more severe, greater immobilization or surgery maybe required to prevent permanent damage.
Causes Of A Toe Fracture
There are many possible causes of a toe fracture. The injury may be caused be stubbing the toe, dropping something on it, or bending it out of position. A stress fracture, also known as a hairline fracture, may be the result of a sudden increase in the intensity of simple exercise, like walking or running.
Symptoms Of A Toe Fracture
There are several symptoms that may indicate a toe has been fractured, including one or more of the following:
- Severe pain increased by touch or movement
- Inability to move the toe
- Dark bruising
- Deformity (abnormal positioning)
Sometimes when a toe, or any bone, is fractured, a popping sound is heard at the moment of impact.
Diagnosis Of A Toe Fracture
In order to diagnose a toe fracture, after a physical examination, the foot is X-rayed to assess the damage. During the physical examination, the doctor looks for swelling, dark bruising, the location of the worst pain, and any abnormality in positioning. The X-ray shows whether there is actually a fracture, as well as its precise location and severity.
Treatment Of A Toe Fracture
Usually, in the case of a minor toe fracture of one of the small toes, home remedies are all that is necessary. These include rest, application of ice, and elevation of the affected foot. In many cases, the injured toe is simply taped to an adjacent toe to protect it from further injury and promote healing. This is known as “buddy taping.” When a toe is buddy-taped, soft padding is placed between the toes to prevent chafing. There are situations in which buddy taping is not possible, such as if the patient has diabetes or peripheral arterial disease, either of which impair circulation, or if the procedure increases the patient’s pain level.
When buddy taping is administered, it is generally left in position for 2 to 4 weeks. The fractured toe usually heals within 4 to 6 weeks.
In rare instances, when the fracture is severe, the toe may require full immobilization to protect it from further injury. This may take the form of a splint, brace, or short leg cast. Surgery is sometimes necessary, most often when the big toe is the one fractured. Without treatment of a severe fracture, there may be serious consequences, such as limited mobility, deformity of the toe in question, and long-term pain.