Jones fracture of the fifth metatarsal: Is operative intervention justified? A systematic review of the literature and meta-analysis of results. Issue 4 (December 2015)

• Record Type: Journal Article
• Authors: Yates, Jeffrey; Feeley, Iain; Sasikumar, Sanskriti; Rattan, Gurender; Hannigan, Ailish; Sheehan, Eoin
• Is Part Of: Foot. Volume 25:Issue 4(2015:Dec.)
• Page Start: 251
• Page End: 257
• Publication Date: 2015-12
• Subjects: Jones fracture -- Surgical -- Conservative -- Management -- Nonunion -- Time to union; Foot -- Diseases -- Periodicals; Foot -- Surgery -- Periodicals; Foot Diseases -- Periodicals; Foot -- surgery -- Periodicals; Pied -- Maladies -- Périodiques; Pied -- Chirurgie -- Périodiques; Pied -- Lésions et blessures -- Périodiques; Foot -- Diseases; Foot -- Surgery; Periodicals; Electronic journals; Electronic journals; 617.585005
• DOI: 10.1016/j.foot.2015.08.001
• Languages: English
• ISSNs: 0958-2592

Abstract

Highlights: Metatarsal fractures occur commonly at 6.7 fractures per 10, 000 people. There is lack of clarity in classifying and treating the Jones' fractures. The natural history of healing of Jones' fractures has been shown to be suboptimal. Our meta-analysis showed surgery gives significantly decreased odds of nonunion. We found surgery had faster rates of union, return to sports and activity. Abstract: Background: This study assesses the outcomes of surgical vs. conservative management in the treatment of the Jones fracture. Materials and methods: A systematic review using four databases from their inception until September 2014 was undertaken. Six studies were found evaluating operative therapy compared to conservative treatment. Results: Six relevant studies were included, with a total of 237 patients. Of these, 51% were treated non-operatively, and 49% had surgical intervention. Those in the non-operative group were found to have a significantly higher odds ratio (OR) of fracture non-union (OR 5.74, 95% confidence interval (CI) 2.65–12.40, P < 0.001). Studies also reported a prolonged healing time and a longer time to return to sports. Of the trials with time to union as an outcome measure, 3 of 4 trials found favourable results in the operative cohort. Conclusions: Surgical intervention is recommended for patients presenting with a Jones fracture as it is found to result in a lesser non-union rate and an improved time to union.