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5th Matatarsal break, is it a true Jones Fracture?

Discussion in 'Ask your questions here' started by scubasteve, Sep 5, 2009.

  1. scubasteve

    scubasteve New Member


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    Hello All… my name is Steve and I'm from the Boston area...

    I unfortunately suffered a fracture on the base of my 5th metatarsal last weekend and I am hoping if someone on here would be able to give me some advice on of this is in fact a true Jones Fracture or more of an Avulsion fracture.

    I have been reading a lot about it and I'm not sure if the doctor I saw gave me the correct course of action to take care of it because he saw me for 2 seconds and went to get an Aircast and the nurse came back and I tried to ask some questions through the nurse and didn't get and clear answers. I am currently in an Aircast with cruthces and the doctor said no weight bearing on my foot... the nurse said I could take it off to shower, sleep and relax. I am wondering if I should be wearing the cast when I sleep to help keep it immobilized so the tendons will be less like to pull on the bone fragment.

    I do have one thing going for me and that is I have almost no pain (unless the area is touched) and hardly any swelling and the bruise that was over my foot had gone already after 6 days and I haven't even taking Advil or the pain meds I got because of the lack of pain... Is the absent of pain a good thing?

    Here are the x-rays I got on CD from the hospital with a program that I could change the contrast and stuff then I took screen shots.

    ANY ADVISE WOULD BE GREAT, I currently have no health insurance and I'M now wondering if I should spend the money which i don't have to go get a second opinion.
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  2. scubasteve

    scubasteve New Member

    more x-rays

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  3. FootDoc

    FootDoc New Member

    DISCLAIMER:
    THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS-ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
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    I don't know why just an air cast. I agree with no weight-bearing, but don't see how you are going to safely shower on one foot. I think you were remiss in leaving the hospital without all of your questions answered and with instructions on which you felt confident. I would recommend that you go back and demand full explanations and instructions at no additional charge from that doctor and then determine whether you would be more comfortable with having a second opinion.
     
  4. scubasteve

    scubasteve New Member

    FOOT DOC... Thank you for your reply... with your statement I assume if I was your patient you would have put me in a plaster cast not an Aircast?

    I do planning on going back to the doctor but I was hoping you may be able to help me classify it is a Jones fracture or not? I understand if you can't but looking at my x-rays you basically have the same information that the orthopedic doctor I saw used.

    I have read your disclaimer and still want your opinion. I just want to be more educated in the issue I find myself in so when I go back to the doctor I can have a more reveling discussion since I will understand it a little better

    Also I hoped you could answer is the absent of pain and a not a lot of swelling a good thing or does it make no real difference in the situation?
     
  5. FootDoc

    FootDoc New Member

    DISCLAIMER:
    THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
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    First of all, I do not make diagnoses without benefit of examination. The use of names associated with disease conditions instead of pathological descriptions tend to cause confusion when conditions do not meet the precise criteria. Besides being said to be located 1.5-2.5 cm from the base of the 5th metatarsal, true Jones fractures generally invade the articulation between the 4th and 5th metatarsal. Avulsion fractures generally invade the 5th metatarsal-cuboid articulation. I'm not sure what the arrows on your x-rays are intended to point out, but from what I am able to see on the photos, it appears to me that your fracture invades the 5th metatarsal-cuboid joint, but is very close to, if not invading the 4th-5th metatarsal articulation. So call it what you will. It also appears that you may have a probably old and healed fracture of the very tip of the styloid process. Both pain and swelling are unreliable diagnostic markers and vary from patient to patient. The main issue with fractures near the diaphysis of the 5th metatarsal is that that location is typically poorly vascularized and subject to poor healing.
     
  6. scubasteve

    scubasteve New Member

    This is what i have heard.

    Do you recommend and sort treatment to stimulate more blood flow to this area.

    The doctor did say to drink a lot of milk?... what is considered an amount that it would help the healing of the broken bone.

    Is there anything i can do to help the process other than use a bone stimulator?
     
  7. FootDoc

    FootDoc New Member

    DISCLAIMER:
    THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
    ***********************************************************
    It is not a case of abnormally restricted blood supply. The vascularization to that area of the bone is normally somewhat poor. I would avoid activities which restrict blood flow such as smoking. I don't know that drinking milk will do anything unless you have a calcium deficiency, but I'm not going to tell you not to follow your doctor's recommendations. I have no particular recommendations other than good immobilization. Leave the particulars up to a qualified attending.
     
  8. scubasteve

    scubasteve New Member

    Thank you for your answers, I appreciate your time!!
     
  9. Cary

    Cary New Member

    I just broke mine last night and had it treated this morning. I have an 80% break. Is their anything I can do to help it heal, and did your heal all the way? How can I improve blood flow to the area?
     
  10. mary1375

    mary1375 New Member

    Hi ...im new here...but have a couple of questions on May31st I broke my 5th Matatarsal bone (little Pinky), its been now like 12 days can I try steping on it or is it to soon...I have a big party on June 26 will I be able to walk by then ..please help me out
     
    Last edited: Jun 11, 2010
  11. FootDoc

    FootDoc New Member

    Sites such as this are neither intended nor are they appropriate for offering case-dependent advice or instructions which require intimate knowledge of the specific situation. They are instead appropriate for general and educational information which will not be taken as specific directions or instructions as to how proceed with one's individual care. That's why you consulted a doctor to diagnose your case administer your treatment, and that doctor should be contacted by you whenever you have questions regarding your on-going care. If you have a general question about fractures, the answer to which may or may not be germane to your individual situation, I will attempt to answer it.
     
  12. abedashi

    abedashi Guest

    This appears to be a true Jone's farccture as the fracture goes into the 4th-5th metatarsal articulation. Not a styloid avulsion fracture. There is a risk of non-union andsometime these are fixed with a screw or pin. I have treated soem of these concervatively based on patients' preferences and some have healed in a fibercast (patient compliance to be considered here). Would not recommend an aircast. Some of them may still result in non-union and may require bone grafting later on. Some orthopods do not like taking the risk of non-union and place a screw from the start. Hope this helps.

    Allan.
     
  13. Unregistered

    Unregistered Guest

    This appears to be a true Jones fracture as the fracture goes into the 4th-5th metatarsal articulation. Not a styloid avulsion fracture. There is a risk of non-union and sometimes these are fixed with a screw or pin. I have treated some of these conservatively based on patients' preferences and some have healed in a fiberglass cast (patient compliance to be considered here). Would not recommend an aircast. Some of them may still result in non-union and may require bone-grafting later on. Some orthopods do not like taking the risk of non-union and place a screw from the start. Hope this helps.

    Allan.
     
  14. FootDoc

    FootDoc New Member

    Do you not realize that the fracture to which you ostensibly refer occurred 9 months ago?
     
  15. ...Ok, how did you post your pics? I can't figure out how!
     
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