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jones fracture update

Posted by scott on 3/07/03 at 09:59 (112112)

well had a new x ray and its looking like no union still. dr wants to go 8-12 more weeks in non weight bearing cast if no union then surgery

im not interested in surgery unless absoulutley needed, the nurse that applied my new red cast said a women was in her cast non weight bearing for 25 weeks then union occured and she heled without surgery so i guess its just a long healling process,wont be wearing the new birks ant time soon though

Re: jones fracture update

bgcped on 3/07/03 at 10:15 (112113)

How did you do it? was it stress fx or did you have a trauma to it?

Re: jones fracture update

Dr. Z on 3/07/03 at 11:02 (112124)

This is an area with very little local circulaton. How about using a bone stimulator with your non-weight bearing cast. That could knick up the healing. This is what ESWT is being used for in Europe- non-union of fractures

Re: jones fracture update

scott on 3/07/03 at 13:40 (112151)

the bone stim was mentioned, i will look into it more.

the injury was orginally several months back and i basically re broke it tripping off a industrial type curb..
so its actually broken in same spot. not sure if this makes it a more slow healer or will result in non union. does 12 weeks seem resonable to be in the cast?? im told if healing starts then i will be prolonged in the cast to allow a full healing to occur. also found it interesting that any bone actually can be healed but not fully for many months.
my dr uses a cast with a gore tex inside so its not all that uncomfortable, just wish i could walk on it!!
im still tempted to walk a bit on it

Re: jones fracture update

Ed Davis, DPM on 3/07/03 at 15:03 (112162)

Scott:

Twelve weeks is not necessarily a long time to be casted for a Jone's fracture. I agree with Dr. Z that one should consider electronic bone stimulation at this point.
Ed

Re: jones fracture update

scott on 3/08/03 at 12:28 (112258)

does a stimulator go outside the cast??

would i still require 12+ weeks to heal?

do u agree with non weight bearing the enire time?? im so tempted to walk some onit

Re: jones fracture update

Dr Z on 3/08/03 at 13:14 (112267)

Most do Maybe. Non-weight bearing is the way to go if this is a true jones fracture. A true jones fracture is where the break is just above the neck of the base of the 5th metatarsal. If we are talking about the base itself then thisn't a jones fracture and different treatment plan is needed

Re: jones fracture update

scott on 3/09/03 at 11:49 (112334)

yup

i do have this jones fracture... ive only been in the cast a few weeks and i have to go at least 12 before possible wweight bearing they said!
i guess it couldeven be longer
i really dont want surgery so i guess i will keep with the slow way

my cast is from toes to just under knee. seems like a big cast for the foot?/

i am told its standard procedure.
am i going to lose a lot of muscle from being in the cast?

is this type of fracture susseptable to re fracture in future??

Re: jones fracture update

BGCPed on 3/09/03 at 19:27 (112375)

It is in somce cases prone to re fx. If you are athletic stay away from shoes that have air in the heels or bend and twist easily. If you do any court sports or opne that require cutting and turning i.e. soccer, b-ball. If you have a subtle or not so subtle cavus foot. I would guess that about 90% of jones fx I see that are chronic have sublte cavus and almost all will have a plantarflexed 1st met head.

I hardly ever see a pronated foot with that fx unless it is blunt trauma. I dont know where to get statistics in sports but I would bet there is an increase in them starting about 4 years ago. If anybody can find some stats on that I would be interested

Re: jones fracture update

john h on 3/10/03 at 09:49 (112417)

BG: I have read various articles to stay away from air shoes if you have any problems with your Achilles tendon. I guess the little pumping action allowed by the air pockets are constantly stretching the tendon as you walk.

Re: jones fracture update

scott on 3/10/03 at 12:22 (112435)

would i be bettr off with all toes casted ! the little toe is pretty much in the cast but the others are all free and i tend to move them a lot

also my cast goes up to my knee.

im getting beter about keeping it elevated. i guess its crutches for me for a while.

12 weeks + just seems so long. my dr had a women with same injury go 25 weeks ina cast and crutches then she was fine. so i guess i just have to let time do its thing or go under for surgery

Re: jones fracture update

BGCPed on 3/10/03 at 16:19 (112463)

Air in the heel is mostly a stupid design. I think it makes the shoe too unstable. I also believe a few companies have spent way toooooo much money pushing that feature. If you notice many of the air bladders are now being encased in firm frames or blostered by harder materials. It is reverse of what they touted in the first place.

I was talking to a trainer that has been around a long time and asked him. He said in last few years he feels like he is taping every players ankles, more than before. If anybody knows a link to any papers on this that would be great. I think the foot/ankle soc did one about a year or so ago

Re: jones fracture update

A Manoli MD on 3/10/03 at 21:22 (112498)

if it's a TRUE jones fracture, why not have a screw put in it, by someone who knows how to do it with some local grafting from the reamings, and it can be healed in most people in 4-6 weeks. much better then 25 weeks on crutches!!!!

am2

Re: jones fracture update

BGCPed on 3/11/03 at 20:06 (112599)

sounds logical to me. no need to rush surg but 25 wk on crutches is a haul. i did 6 weeks and thought i was gonna die. made my arms look like hulk hogan