Original researchThe use of external fixation for treatment of the acute jones fracture: a retrospective review of 10 cases4
Section snippets
Materials and methods
This was a retrospective, clinical investigation of patients undergoing external fixation of type I Jones fractures in the senior author’s (C.M.L.) private practice from 1996 to 2001. Patients undergoing external fixation for midshaft or open fractures were excluded. Patients were only considered candidates for external fixation if they were young and active. Although the decision to perform the procedure was made on a case-by-case basis, this technique was generally reserved for those patients
Results
Comprehensive patient data can be found in Table 1. Ten patients met the inclusion criteria; there were 9 men and 1 woman. The mean patient age was 25.2 years (range, 15 to 49 years). Telephone follow-up inquiry was performed at an average 46 months postoperatively (range, 14 to 79 months). There were 2 high school basketball players, 1 amateur competitive tennis player, 1 football player, and 1 softball player. Each of these patients sustained their fracture while playing their chosen sport.
Discussion
External fixation offers several potential benefits in the treatment of acute Jones fractures. The procedure is quick and relatively easy to perform, decreasing surgical time. As with percutaneous screw fixation, external fixators obviate the need for extensive soft-tissue dissection. In addition, the possible anatomic concerns associated with the placement of intramedullary screws are avoided. External fixators can not only provide stability but also may be adjusted and decompressed, allowing
Conclusion
Given that external is quick, technically simple to perform, and yields clinical and radiographic healing rates comparable with intramedullary screw fixation, this technique provides a useful alternative to traditional fixation methods and may be included in treatment options for this fracture.
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Cited by (14)
Nonunion of fifth metatarsal fractures
2014, Foot and Ankle ClinicsCitation Excerpt :They concluded that closed intramedullary screw fixation is an excellent treatment. Many other investigators have reported good outcomes,8,22,36,37,40,41,52,56–71 and recent refinements in technique focus on the type and size of screw that is required, whether hardware should be removed, and whether supplementary grafting is required. Reports of screw breakage prompted investigation into the size and type of screw required.59,64,65,68,72–74
Treatment of Acute Jones Fracture with Ilizarov External Minifixator: Case Series of Six Elite Athletes
2013, Journal of Foot and Ankle SurgeryCitation Excerpt :The published data on the use of external fixation in the treatment of acute Jones fracture in athletes are insufficient. In the only published study of external fixation of Jones fracture, the average interval to return to preinjury activity levels was 9 weeks (23), longer than the 6.7 weeks we observed in our study. Most external minifixators for the treatment of Jones fracture are applied on the lateral aspect of the fifth metatarsal bone, with special attention to place the apparatus above the sole to allow early weightbearing.
Interventions for treating proximal fifth metatarsal fractures in adults: A meta-analysis of the current evidence-base
2011, Foot and Ankle SurgeryCitation Excerpt :In such cases where the anatomical reduction cannot be maintained with conservative methods, surgical procedures are indicated. Procedures are performed using open or closed reduction methods via a variety of orthopaedic fixation techniques including intramedallary screws, Kirschner (K)-wires, tension-band wires, metal plates and external fixators [7,10,22–25]. The management of these injuries is controversial [4,10].
Metatarsal Fractures
2010, Clinics in Podiatric Medicine and SurgeryCitation Excerpt :Individualized treatment is recommended. Other surgical treatments have been described, including percutaneous pinning,50 tension band wiring,51 and external fixation.52 Medullary curettage and bone grafting is used for nonunion,23,36 which can be done with plate fixation or even in conjunction with intramedullary screw fixation (Fig. 18).
Fractures of the Forefoot
2006, Clinics in Podiatric Medicine and Surgery
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None of the authors received any financial support from any external source. None of the authors have any conflict of interest with the products used in this study.
- 1
Director, Podiatric Medical Residency Program.
- 2
Associate Director, Podiatric Residency Program.
- 3
Research Director, Podiatric Residency Program.