|
Year |
2002 |
|---|---|
|
Question Number |
116. |
|
Category |
Foot and Ankle |
Question
A 30-year-old professional athlete injured the lateral aspect of his right foot 1 week ago. Examination reveals tenderness only at the proximal aspect of the fifth metatarsal. A radiograph is shown in Figure 22. Based on these findings, what is the best course of action?
1. Ankle-stirrup
2. Short leg cast
3. Postoperative hard shoe
4. Fracture brace
5. Internal fixation
Figures
Answer (click for answer)
Preferred respones: #5
Figure 22 depicts a true Jones fracture in the proximal metaphysis of the 5th metatarsal. It is not to be confused with a peroneus brevis avulsion fracture, which occurs more proximally. Treatment for the Jones is surgery for professional athletes. It is also surgery with failed casting/NWB (x4-6wks) management for the rest of us. Poor results are associated with ORIF using hardware other than a 4.5 mm ASIF maleolar screw.
Reference: Beskin, JL. Chapter 19: Injuries to the Midfoot and Forefoot, in OKU Foot and Ankle 2, eds. Mizel, Miller, and Scioli, Rosemont IL, 1998, pp. 248-249.