Percutaneous Surgery for Fifth Metatarsal Fracture
Dr. Lopez performs percutaneous surgery for fifth metatarsal fractures. Discover all the important information about the procedure.
Fifth Metatarsal Operation – Everything You Need to Know About Jones Fracture
Before explaining all the steps of the fifth metatarsal operation, let's first understand what a Jones fracture really is.
A Jones fracture is a fracture of the fifth metatarsal, one of the five long bones of the foot. More specifically, it occurs in the middle part of the bone, about 1.5 centimeters from the base.
Causes of Jones Fracture
A Jones fracture is typically traumatic in origin. It is usually caused by sudden twisting or repeated stress on the foot, as can happen in sports such as running, basketball, or football. It can also be the result of a complication from a foot deformity, such as a high arch, for example, leading to a stress fracture.
Symptoms
Symptoms of a Jones fracture include foot pain that worsens with physical activity, swelling, and bruising in the affected area, as well as difficulty walking. If you suspect a Jones fracture, it is important to consult a doctor for diagnosis and appropriate treatment, as an untreated fracture can lead to short-term, medium-term, and long-term complications.
Diagnosis of the Condition
Dr. Lopez specializes in percutaneous surgery for foot fractures. You will receive comprehensive care throughout the treatment journey: before, during, and after the procedure.
A Jones fracture is an orthopedic emergency and should be promptly addressed (ideally within 10 days), especially in cases of skin involvement or visible displacement.
As a first step, a precise diagnosis of the condition and fracture must be established. The surgeon begins with a clinical examination of the foot. During this consultation, Dr. Lopez inquires about the patient's symptoms and pain.
Medical imaging tests will be necessary to confirm the diagnosis.
X-rays
X-rays are typically the initial step in diagnosing a Jones fracture. They allow visualization of the bone and detection of fractures. However, it is possible that a Jones fracture may not be visible on X-rays immediately after the injury, especially if it is recent and minimally displaced. In such cases, follow-up X-rays may be required.
Computed Tomography (CT) Scan
If X-rays are inconclusive or if a Jones fracture is suspected but not detected on X-rays, a CT scan may be recommended. CT scans can provide more detailed 3D images of the bone and help detect a fracture that is not visible on X-rays.
Magnetic Resonance Imaging (MRI)
MRI uses magnetic waves to create detailed images of soft tissues and bones, which can help detect a Jones fracture and assess the extent of damage to surrounding soft tissues.
Fifth Metatarsal Fracture: Rehabilitation and Orthopedic Treatment
In the case of a fifth metatarsal fracture, rehabilitation and immobilization may be sufficient for treatment. In some cases, a Jones fracture can be treated orthopedically without surgery. In this scenario, treatment involves complete immobilization of the foot with a splint or removable boot. Dr. Lopez will provide all the necessary information to ensure a full recovery. Weight-bearing on the affected foot is prohibited for approximately 45 to 60 days. Elevating the ankle is recommended to reduce swelling. To reduce the risk of deep vein thrombosis, an injection-based treatment may be administered.
If the pain is too severe, the surgeon may prescribe pain relief medication for several days.
After the immobilization period, full weight-bearing on the foot is possible. After 6 weeks of orthopedic treatment, the surgeon will perform a follow-up X-ray of the Jones fracture. Dr. Lopez will also prescribe physiotherapy sessions for post-fracture rehabilitation of the fifth metatarsal.
Percutaneous Surgery for Jones Fracture
Percutaneous surgery for Jones fracture may be considered in the following cases:
- Displaced fracture
- Lack of signs of healing after orthopedic treatment (nonunion)
- Recurrence of the fracture
- High-level athlete
- Excess weight
In these cases, without fifth metatarsal surgery, several complications may arise, such as chronic pain, functional impairment during walking, and the inability to resume sports activities.
Anesthesia
A preoperative consultation with an anesthesiologist must take place before the procedure. The purpose of this consultation is to determine the type of anesthesia the patient will receive during the minimally invasive foot surgery. During this consultation, the anesthesiologist will assess the patient's overall health and medications. Depending on the case, medication may be prescribed before or after surgery to minimize the risk of complications, such as anticoagulants, antibiotics, pain relievers, and anti-inflammatories.
Dr. Lopez generally prefers, when possible, locoregional anesthesia. This type of anesthesia numbs the operated foot as well as the toes and part of the leg. Locoregional anesthesia allows for effective pain relief even after the surgery, helping to alleviate pain effectively.
Surgery
When feasible, Dr. Lopez will perform Jones fracture surgery using the percutaneous technique. A tourniquet is applied to limit blood flow to the operated foot. The surgeon then makes an incision on the lateral side of the foot at the base of the fifth metatarsal.
In the case of a recent trauma, the Jones fracture is fixed by inserting a screw into the fifth metatarsal within the bone cavity. The screw passes through the fracture, allowing compression and promoting healing.
If the fracture is old, percutaneous fracture reduction or a spongy bone graft may be performed during the same surgical procedure.
The incision is then closed with absorbable sutures.
In some cases, the surgeon may insert pins into the fifth metatarsal.
The minimally invasive fifth metatarsal surgery is performed on an outpatient basis. The duration of the procedure ranges from 30 to 60 minutes, depending on the surgical techniques employed. The patient can return home the same evening.
Post-Operation Follow-Up for Jones Fracture
Dr. Lopez will provide all the necessary instructions for the follow-up of the Jones fracture surgery.
Pain Management
The surgeon places great importance on pain management. The use of locoregional anesthesia initially effectively relieves the patient. At the end of the surgery, the patient will be prescribed pain relief medication for long-term pain management.
Resumption of Activities
After the surgery, the foot must be immobilized with a splint for approximately 45 days. Weight-bearing on the operated foot is limited for 45 days.
The patient can move with crutches without putting weight on the foot. Walking can resume between 30 and 60 days after the surgery.
Driving can be resumed after 45 days following the operation.
In most cases, gentle sports activities can be resumed from the 8th week post-surgery.
In the case of a fifth metatarsal fracture, the average time off work is 1 to 3 months.
Post-Operative Care
To reduce swelling, several guidelines must be followed:
- Upon returning home, it is necessary to ice the operated foot regularly (for about 20 minutes in the morning and evening).
- Rehabilitation sessions for the fifth metatarsal fracture and its surgery will be prescribed. You can also perform self-rehabilitation by moving your toes several times a day.
- The surgical hardware does not need to be removed unless it causes discomfort.
Post-operative follow-up must be established after the surgery. You will need to attend a minimum of 3 consultations:
- A consultation on the 21st day to check the dressing.
- A consultation on the 60th day for control X-rays.
- Follow-up may be extended on a case-by-case basis.
Fifth Metatarsal Fracture and Surgery: Possible Complications
In the case of surgical fixation of a fifth metatarsal fracture, complications may arise:
- Deep vein thrombosis
- Stiffness
- Infection
- Poor foot healing
- Recurrence
- Arthritis
Like all surgeries, percutaneous surgery for Jones fracture carries risks of complications. Dr. Lopez and his team adhere to recommendations to minimize the occurrence of complications.
The informations on the page is provided for information only, it evokes general cases: your situation is specific.
Dr Julien Lopez, orthopedic foot surgeon in Nice welcomes you and advises you for your plantar aproneuritis.
