Is It a Sprain or a Jones Fracture?

Is it possible to think you only have a sprained ankle but it is actually a Jones fracture?

It would be fair to say that, while the Jones fracture is considered by healthcare professionals to be one of the most serious fractures to the foot, many people have never heard of it. This is true even though it is actually very common. 

What is a Jones fracture? This particular fracture occurs in the fifth metatarsal bone, which is the bone located at the base of the little toe. The fracture of this bone is often the result of a severe sprain to the ankle or what is referred to as an inversion injury. An inversion injury is when the foot is twisted in such a way as to cause the ankle to roll inward. Trauma, overuse, or long-term stress can also be the cause of a Jones fracture.  

 The Jones fracture got its name from a British surgeon, Sir Robert Jones, who sustained it himself while dancing one evening and then later wrote up its description in the Annals of Surgery in 1902.

One of the reasons that the Jones fracture is considered challenging is that it occurs in an area of the foot where there is a particularly low supply of blood. This can mean that it will require more time for healing, or worse, that complete healing does not take place. In addition, treatment for a Jones fracture can be delayed due to late diagnosis. This often happens with a severely sprained ankle. The pain of the fracture is attributed to the ankle sprain, and the fracture remains untreated until the symptoms of the sprain have subsided, and there is still pain in the foot.   

Sprained Ankle or Jones Fracture?

It can be tempting to minimize the potential seriousness of a sprained ankle simply because they are so common. Estimates of how many times an ankle sprain occurs varies wildly, from around 2 million a year in the U.S., according to the American Academy of Family Physicians (AAFP) to a claim of over 10 million per year from the National Athletic Trainers’ Association (NATA). These estimates also come with the caveat that they likely underrepresent the total number due to so many going unreported. 

Despite the fact that sprained ankles happen so often, this does not mean they are not serious. A minor sprain may only cause a little swelling and temporary tenderness but one that is more severe can come with extreme pain, as well as considerable swelling and bruising. This makes self-diagnosis potentially troublesome because it would be easy to miss additional injuries. If this includes a Jones fracture, the injury may become chronic and eventually require surgery. 

If you think there is any possibility that you have done more than twist an ankle and maybe have a fracture, you should seek medical attention as soon as possible. The following symptoms are red flags, especially if they do not subside quickly: 

  • Pain, severe when putting weight on the injured foot
  • Bruising
  • Swelling
  • Immobility

If you have questions about a Jones fracture or about any other foot or ankle concerns, Dr. Christopher Hubbard is a board-certified Orthopedic Surgeon with Ortho-Care Wayne in Passiac County New Jersey and is the former Chief of the Foot and Ankle Service at Mount Sinai Beth Israel in NYC.

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