![]() In comparison to an avulsion fracture, or pseudo-Jones injury, the Jones fracture is more likely to fail conservative management. The patient in this question has an acute proximal diaphyseal fracture, or Jones fracture. Stress fractures typically exit or extend distal to the intermetatarsal joint. Acute proximal diaphyseal fractures extend into or towards the intermetatarsal joint. Styloid avulsion fractures exit proximal to the intermetatarsal joint. The easiest way to distinguish among the fractures is to locate the medial tip of the fracture line and compare its location to the intermetatarsal joint. There are three basic types of fractures including tuberosity avulsion fractures, acute proximal diaphyseal fractures, and stress fractures of the proximal diaphysis. The fifth metatarsal can be divided into three parts: the tuberosity, the metaphysis and the proximal diaphysis. Suboptimal treatment can lead to delayed union, re-injury and chronic disability. A difference in millimeters of location can lead to a vastly different prognosis and treatment plan. What is the correct diagnosis in this patient?įractures of the proximal fifth metatarsal pose an important diagnostic challenge. Non-union is associated with pain, poor ambulation, and potential need for surgery.Ī 22-year-old man presents to the emergency department with foot pain after landing on his foot improperly while playing basketball last night. Athletes may be treated with intramedullary screw fixation.
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