Foot & Ankle
Jones Fracture
Non-Operative & Operative management
About Your Injury
A Jones fracture is a fracture at the junction of the base and shaft of the 5th metatarsal (Zone 2–3).
Non-Operative Management
Jones fractures can often be safely and effectively managed without surgery, although they are treated more cautiously than other 5th metatarsal fractures because of the poor blood supply in this region. The decision is individualised to each patient.
Recovery Timeline
Weeks 0–6
Non-weight-bearing cast or boot — this is stricter than for a standard 5th metatarsal fracture, given the higher risk of delayed union.
Weeks 6–8
Repeat X-ray to assess healing before any weight-bearing begins.
Weeks 8–12
Gradual, protected weight-bearing if healing is progressing.
3–4 months
Return to normal footwear and daily activity once healed.
Follow-Up Schedule
2 weeks
Clinical review to confirm the treatment plan.
6 weeks
X-ray to check for early signs of union.
3 months
If healing is delayed at this point, surgical fixation may be discussed.
Nonunion
Nonunion means the fracture fails to heal. It is more common in Jones fractures than most other foot fractures, due to the relatively poor blood supply at this part of the bone. We monitor for it with X-rays through follow-up, with the 6-week review the key checkpoint. To reduce the risk: strictly follow the non-weight-bearing protocol for the full duration advised, maintain a healthy, balanced diet to support bone healing, and avoid all nicotine intake — the single biggest modifiable risk factor for nonunion.
Operative Management
This region has a relatively poor blood supply, giving Jones fractures a higher risk of delayed union or nonunion than other 5th metatarsal fractures — surgery is often recommended, particularly for athletes or those wanting a faster, more reliable return to activity.
A single screw is placed down the shaft of the bone (an 'intramedullary screw') to compress and stabilise the fracture. Despite this fixation, nonunion remains a recognised risk with Jones fractures — and a further fracture can occasionally occur in the bone just beyond the tip of the screw. This is monitored closely with follow-up X-rays. The procedure is performed under general anaesthetic, with local anaesthetic infiltration at the time of surgery for good pain control in the first 12–24 hours afterward, and is usually done as day surgery.
Recovery Timeline
Weeks 0–2
Boot, non-weight-bearing.
2 weeks onward
Weight-bearing as tolerated in the boot.
6 weeks
Weaning from the boot into good, stable, supportive shoes.
3–4 months
A gradual, protocol-based return to sport and full activity, guided by a good physiotherapist, once union is confirmed.
Follow-Up Schedule
2 weeks
Wound check and start of weight-bearing in the boot.
6 weeks
X-ray to check for early signs of union.
3 months
X-ray to confirm union and clear return to sport.
Association with Stress Fractures and Cavus Feet
Jones fractures are strongly associated with a high-arched (cavus) foot, which shifts extra load onto the outer border of the foot and the base of the 5th metatarsal — this is often why the fracture occurred in the first place, and it also predisposes to stress fractures at the same site. If this underlying alignment is not addressed, it can contribute to delayed healing or refracture. In some patients, a larger cavovarus foot correction is required alongside fixation of the fracture, to correct the underlying cause and give the bone the best chance of healing.
Hardware Removal
The screw is not routinely removed. Removal is only considered if hardware becomes symptomatic — for example, causing local irritation with footwear.