Systematic review and meta-analysis (Attia et al. 2021, American Journal of Sports Medicine)
Operative management leads to higher union rates and faster return to sport in athletes
Meta-analysis (Wang et al. 2020, PloS One)
Surgery: shorter time to union, lower nonunion rate vs. conservative management
2025 International Foot and Ankle Sports Consensus (Balboni et al.)
Operative fixation recommended for elite athletes as primary treatment
Coleman and Guyton (2020, Foot and Ankle Clinics)
Nonoperative management remains reasonable for nonathletic patients
Intramedullary screw evidence
Screw diameter and length critical for fixation strength
Larger diameter screws (4.5 to 6.5 mm) provide superior pullout strength
Screw must span entire fracture zone to prevent toggle
Kavanagh et al. (2024): union rate in general population after screw fixation is high
Early weight-bearing after fixation is safe
Looney et al. (2020): no increased delayed union with early weight-bearing protocol
Waverly et al. (2018): early weight-bearing protocol well tolerated
ICD-10 coding
S92.352A: Displaced fracture of fifth metatarsal bone, initial encounter
S92.352D: Displaced fracture of fifth metatarsal bone, subsequent encounter
S92.352G: Displaced fracture of fifth metatarsal bone, subsequent encounter with delayed healing
M84.375: Stress fracture of fifth metatarsal
Patient Discharge Instructions
copy discharge instructions
Diagnosis and overview
You have been diagnosed with a Jones fracture
This is a specific type of break in the fifth (outer) metatarsal bone of your foot
This fracture has a higher risk of not healing than other foot fractures
It requires close follow-up with an orthopedic (bone) specialist
Weight-bearing restrictions
Non-weight-bearing on the injured foot until cleared by orthopedics
Use crutches or a knee scooter to avoid putting weight on the foot
Do not walk on the foot even for short distances
Keep the splint dry and intact
Cover with a plastic bag while showering
Do not remove or modify the splint
Pain management
Acetaminophen (Tylenol) 500 to 1000 mg every 6 hours as needed for pain
Ibuprofen (Advil, Motrin) 400 to 600 mg every 8 hours with food if tolerated
Avoid if you have kidney problems, stomach ulcers, or are pregnant
Elevate the foot above heart level to reduce swelling and pain
Ice to the injured area 20 minutes on, 20 minutes off for the first 48 to 72 hours
Place a cloth between the ice and skin to avoid frostbite
Follow-up instructions
Orthopedic appointment within 5 to 7 days of discharge
This is essential and should not be missed
Serial X-rays will be taken every 2 to 4 weeks to track healing
Recovery time is typically 10 to 12 weeks for nonoperative management
Surgery may be recommended at your follow-up visit depending on X-ray findings and your activity level
Return to the emergency department immediately for
Increasing pain in the foot or leg that is not controlled by medications
Numbness, tingling, or color changes (pale, blue, cold) in the toes
Splint becomes too tight or feels excessively painful
Swelling or redness spreading up the foot or ankle
Fever above 38.5 degrees Celsius
Wound drainage or foul smell under the splint
Any concern about the foot not healing or a new injury
References
Guidelines and key sources
Primary clinical references
Silver S, Williams E, Plunkett ML. Common Foot Fractures. American Family Physician. 2024. PMID 38393796
Comprehensive review of Zone 1, 2, and 3 fifth metatarsal fracture classification and management
Metzl JA, Bowers MW, Anderson RB. Fifth Metatarsal Jones Fractures: Diagnosis and Treatment. Journal of the American Academy of Orthopaedic Surgeons. 2022. PMID 34932521
Evidence-based guidance on operative vs. nonoperative management
Bušková K, Bartoníček J, Rammelt S. Fractures of the Base of the Fifth Metatarsal Bone: A Critical Analysis Review. JBJS Reviews. 2021. PMID 34673663
Detailed review of risk factors including pes cavus, diabetes, and peripheral vascular disease
Surgical outcome studies
Attia AK, Taha T, Kong G et al. Return to Play and Fracture Union After the Surgical Management of Jones Fractures in Athletes: A Systematic Review and Meta-Analysis. American Journal of Sports Medicine. 2021. PMID 33740393
Supports operative management for athletes: higher union rates, faster return to sport
Wang Y, Gan X, Li K, Ma T, Zhang Y. Comparison of Operative and Non-Operative Management of Fifth Metatarsal Base Fracture: A Meta-Analysis. PloS One. 2020. PMID 32790794
Meta-analytic evidence favoring surgery for active patients
Kavanagh AM, Burgess BJ, Garras D, Therien AD, Vora A. Rate of Bony Union After Jones Fracture Fixation in the General Population. Journal of Foot and Ankle Surgery. 2024. PMID 40056968
Weight-bearing and postoperative protocols
Looney AM, Renehan JR, Dean DM et al. Rate of Delayed Union With Early Weightbearing Following Intramedullary Screw Fixation of Jones Fractures. Foot and Ankle International. 2020. PMID 32691621
Waverly BJ, Sorensen MD, Sorensen TK. Early Weightbearing Protocol in Operative Fixation of Acute Jones Fractures. Journal of Foot and Ankle Surgery. 2018. PMID 29685559
Bucknam RB, Scanaliato JP, Kusnezov NA et al. Return to Weightbearing and High-Impact Activities Following Jones Fracture Intramedullary Screw Fixation. Foot and Ankle International. 2020. PMID 31904264
Consensus and sports medicine guidelines
Balboni JM, Semelsberger SD, Boggiano VJ et al. Jones Fractures in Elite Athletes - 2025 International Foot and Ankle Sports Consensus and Systematic Review. Knee Surgery, Sports Traumatology, Arthroscopy. 2025. PMID 41451757
Porter DA. Fifth Metatarsal Jones Fractures in the Athlete. Foot and Ankle International. 2018. PMID 29228800
Roche AJ, Calder JD. Treatment and Return to Sport Following a Jones Fracture of the Fifth Metatarsal: A Systematic Review. Knee Surgery, Sports Traumatology, Arthroscopy. 2013. PMID 22956165
Coleman MM, Guyton GP. Jones Fracture in the Nonathletic Population. Foot and Ankle Clinics. 2020. PMID 33543727
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.