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Foot Case 2 Background

Fracture of the 5th metatarsal

In 1902 Sir Robert Jones described a fracture he sustained dancing around a maypole at a military garden party. The term is often misapplied to any fracture of the 5th metatarsal base when in reality there are two distinct fractures that can occur in this area:

1. Jones Fracture. A transverse fracture of the base 5th metatarsal occurring at least 15 mm distal to the proximal end of the bone (a diaphyseal metatarsal fracture).

2. Pseudo-Jones Fracture. A fracture at the base of the 5th metatarsal usually involving the lateral tuberosity (styloid).

It is important to distinguish between the two because their prognosis and management differ significantly. To avoid confusion, it is best to avoid the terms "Jones" and "Pseudo-Jones" when determining management.

Instead, fractures within 1.5cm of the styloid process should be considered "avulsion" fractures, while those beyond 1.5cm from the end of the styloid should be considered "metatarsal" fractures.