Jones fracture

In the Jones fracture is a fracture of the fifth metatarsal bone in the proximal meta- diaphyseal junction without the participation of the tarsometatarsal joint ( usually but the intermetatarsal joint to the metatarsal 4). This fracture is less common than the avulsion fracture of the tibial tuberosity with joint involvement, but the risk of Nichtverheilens (pseudarthrosis ) is significantly higher, especially with conservative therapy. The fracture is named after Sir Robert Jones, in 1902, this fracture has itself incurred during a dance and she described subsequently. In English, this fracture is also mistakenly called Dancer's Fracture.

Anatomy and classification

The Jones fracture was first described in 1902. It runs in the meta- diaphyseal junction transverse to the shaft axis about 1.5 to 2 cm distal to the tarsometatarsal joint, which is not involved. This area is poorly perfused, which favors the formation of pseudarthrosis. The break is almost never moved ( dislocated ). Often also other fractions of the base of the fifth metatarsal to be referred to as " fracture Jones " or " pseudo -Jones fracture ". A classification of fractures of the fifth metatarsal was proposed by Dameron and Quill 1995:

  • Dameron -Quill Type 1: outline of the tuberosity ( avulsion fracture )
  • Dameron -Quill Type 2: fracture in the meta- diaphyseal junction ( true Jones fracture )
  • Dameron -Quill Type 3: Stress fracture of the proximal shaft
  • Dameron -Quill Type 4: distal fractures of the shaft, neck or head

Other authors grouped type 2 and 3 together because the stress fractures are at about the same height in the meta- diaphyseal junction, and seen in type 3 is a delayed or nonunion Jones fracture (chronic Jones ' fracture ). This can be a sclerosis of the medullary cavity, close a widened fracture line and possibly incipient callus formation on a non-acute fracture, with complete obliteration of the medullary cavity at a nonunion. After decreasing healing potential Torg and colleagues proposed a classification. :

  • Torg type 1 - acute fracture
  • Torg type 2 - break with delayed fracture healing in medullary - sclerotherapy
  • Torg type 3 - complete nonunion

In this study, 46 newly diagnosed fractures of types 2 and 3 according to Dameron -Quill were ( ie without the involvement of the tarsometatarsal joint ) is analyzed and thereby 25 times an acute fracture, 12 times an older not yet healed fracture and nine times a complete nonunion detected.

A distinction must be a normal Apophysenfuge consisting aged between 9 to 14 years and a course along which the shaft axis, as well as an accessory ossicle at the tip of the tuberosity of the fifth metatarsal base. This O peroneum observed at about 15% of people.

Therapy

Due to the critical blood supply to the healing is often delayed and bone regeneration is often achieved cast immobilization after 8 to 10 weeks. Top athletes or need of a quick recovery of mobility often occurs osteosynthesis. Be applied, for example, an intramedullary screw fixation, tension band with a K- wire or a mini-plate osteosynthesis.

Swell

  • S. Rammelt et al: Metatarsal fractures. In: Injury 35, 2004, Suppl 2: SB77 -86. PMID 15315882
  • Metatarsalefrakturen at www.foot - trauma.org
Long bone Fibrocartilage callus Process (anatomy)
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