Jones and proximal diaphyseal fractures of the fifth metatarsal are in close anatomic proximity and often are difficult to
differentiate. We determined whether it is necessary to differentiate between these two diagnoses. Retrospectively, the two
diagnoses were identified radiographically using an accepted classification scheme. Initial management is nonoperative; however,
intramedullary screw fixation is performed for competitive athletes, or others with displaced fractures, or delayed union
or nonunion. Outcomes were analyzed using Student’s t tests, whereas nominal data were analyzed using chi square tests. Thirty-two
Jones fractures and 29 proximal diaphyseal fractures were identified. All fractures healed between 4.8 and 9.8 months with
a 78% to 82% patient satisfaction rate. Regardless of treatment, the clinical outcomes were not different between the two
fracture locations. Shorter return to sport time was observed in operatively treated patients. Operatively treated patients
with fracture site sclerosis or medullary canal obliteration on radiographs had lower satisfaction and higher complication
rates than patients without these changes. Based on our findings, we do not find a reason to distinguish between fractures
of the fifth metatarsal in these two locations. We suggest referring to fifth metatarsal base fractures (excluding avulsions)
as Jones fractures.
Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
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patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations
were conducted in conformity with ethical principles of research.