Background: A Jones fracture is a transverse fracture of the V. metatarsal bone, without significant dislocation in the diaphysis junction and metaphyseal metaphysis. This type of fracture is usually associated with a minimal injury mechanism, and is characterized with minimal swelling, absence of hematoma and prolonged healing. The aim of the presented study was to compare the surgical and conservative therapy of Jones fracture. The study was registered in the www.clinicaltrials.gov database, under the ClinicalTrials.gov ID: NCT04037540 on 27th July 2019.
Methods: A total of 27 study subjects were randomized into two groups – Conservative (K): 12, and Operational (O): 15. The study subjects were followed after 6 and 12 weeks using X-ray and the American Orthopedic Foot and Ankle Score (AOFAS). In the absence of X-ray signs of healing and low AOFAS score in Group K, treatment was considered unsuccessful and the patient was indicated for surgical treatment.
Results: Five patients in Group K showed no signs of healing on X-ray after 12 to 6 weeks. These patients also manifested poor AOFAS scores and were indicated for surgical treatment and excluded from the study. Fracture failure was observed in seven patients. Their AOFAS scores were at the least satisfactory and, the patients continued in conservative therapy. After 12 weeks, 6 patients manifested fracture healing on X-ray and the AOFAS score of 100. In one patient who refused surgery, the fracture was not healed after 12 weeks. In Group O, seven patients achieved fracture healing on X-ray after 6 weeks, 8 patients did not show fracture healing. The average AOFAS score after 6 weeks was 97 (excellent). After 12 months, 13 patients showed findings of fracture healing on X-ray. The average AOFAS score was 100 points (maximum).
Conclusions: The results of the study show that 1) Surgical treatment leads to significantly faster signs of healing on X-ray than the conservative one 2) After six weeks of surgery, 93% (14 out of 15) of patients are able to fully load the limb.
Keywords: Jones - Fracture - AOFAS - Herbert screw
Unique protocol ID: FNO-KUCH-01-Jones