Evolution of Technology

Jones Fracture Intramedullary Screw

Intramedullary screws are type of implant designed to sit within the bone being fixated. Benefits of intramedullary fixation include little to no hardware prominence, ease of implantation, and the allowance of micromotion about a fracture site to provide stronger bony healing.

Intramedullary screws can be fully-threaded, partially-threaded or variably-threaded, depending on fixation strategy utilized. They are often cannulated, which allows for insertion over a guidewire. Where strength is of a concern, solid implants can also be used, which provide a much stiffer ultimate fixation construct.

Evolution of Procedure

Jones Fracture Intramedullary Screw Fixation

Recently, surgeons have become much more aggressive with treating Jones fractures surgically in the acute setting. They cite high union, return to play and satisfaction rates as reasons to pursue early operative intervention. While some surgeons elect to utilize a plate and screw construct, intramedullary fixation with specialized intramedullary implants provides rigid fixation with minimally hardware prominence, and delivers high union rates. Studies have regularly demonstrated that patients who undergo intramedullary fixation of Jones fractures predictably reach bony union much more quickly than their nonoperative counterparts, and are able to return to sport and work in a much more expedited timeline.

Evolution of Diagnosis

Jones Fracture

Proximal fifth metatarsal base fractures, or Jones fractures, are a common injury sustained by both athletes and laypeople alike. Often occurring secondary to trauma, Jones fractures occur in a vascular watershed area about the fifth metatarsal base. Owing to the decreased and variable bloodflow in the area, these fractures are prone to nonunion or delayed union.

Traditionally, Jones fractures were treated conservatively, with extended immobilization in a cast, followed by a CAM boot. These treatment modalities however is lengthy, costly, and often leads to high levels of stiffness and diminished athletic performance. It is also associated with high levels of patient dissatisfaction.