Return to Weightbearing and High-Impact Activities Following Jones Fracture Intramedullary Screw Fixation

Abstract

Background:

Although the benefit of primary intramedullary (IM) screw fixation of fifth metatarsal Jones fractures in athletes is clear, limited data support its use in conventional patient populations. This study evaluated radiographic and functional outcomes following primary IM screw fixation in a series of Jones fractures to determine if similar excellent outcomes were achievable.

Methods:

We reviewed the data of 32 consecutive patients who underwent Jones fracture primary IM screw fixation by a single surgeon. Demographic risk factors of interest (age, gender, tobacco use, pertinent medical comorbidities, military service status, and prior nonoperative management) were collected prospectively. Primary outcomes included times to return to full weightbearing, radiographic union, and resumption of high-impact or restriction-free activities. Complications including reoperations were recorded. Categorical data are reported as frequencies, and statistical means with P values are reported for continuous variables. Mean age for the 32 patients was 33.4 years.

Results:

All 32 fractures healed uneventfully, and at mean follow-up time of 24.2 months, overall patient-reported satisfaction was 100%. Overall mean postoperative outcomes are as follows: 3.7 weeks return to full weightbearing, 10.8 weeks to radiographic union, and 13.0 weeks to resumption of restriction-free activities. Among the risk factors assessed, only preoperative peripheral vascular disease (PVD) and/or diabetes mellitus (DM) and active duty military service resulted in significantly increased and decreased time to resumption of restriction-free activities, respectively, but did not impact overall weightbearing or union times. Patient age, gender, and tobacco use had no effects on radiographic or functional outcomes.

Conclusion:

Primary IM screw fixation was a safe, reliable option for all appropriate operative candidates with Jones fractures and may result in similar early weightbearing, osseous healing, and expeditious return to full activities consistently reported in high-level athletes.

Level of Evidence:

Level IV, case series.