Pathoanatomy of the Jones Fracture in Male University Soccer Players

Abstract

Background: Jones fractures are relatively common in soccer players and require an extended recovery period because this type of fracture has a high incidence of delayed union, nonunion, and refracture. There has been some previous research on risk factors for Jones fracture, but no study has yet investigated the effect of the length of the fifth metatarsal bone and the positional relationship of the articular surface of the fifth metatarsal bones and the tarsal bones. Clarification of the characteristics of the foot structure that predispose soccer players to Jones fracture may aid in the prevention of this injury. Purpose: To investigate the association between Jones fracture and foot structure as assessed with a mapping system on weightbearing dorsoplantar and lateral foot radiographs. Study Design: Cohort study; Level of evidence, 3. Methods: We used a mapping system to evaluate the radiographs of 60 feet from 30 university soccer players with Jones fractures and a control group of 60 feet from 60 male university soccer players without Jones fracture. The groups were compared regarding the length of the fifth metatarsal and the positions of the metatarsal and tarsal bones. Results: Analysis of weightbearing dorsoplantar foot radiographs showed that the fifth metatarsal was significantly longer and that its proximal tip was positioned more proximally in the Jones fracture group as compared with the control group. Analysis of weightbearing lateral foot radiographs showed that the reference points for the medial arch were significantly higher in the Jones fracture group than in the control group. Conclusion: This study indicated that the proximally longer fifth metatarsal may cause greater stress at the base of the fifth metatarsal bone because the lever arm becomes long. In addition, high medial longitudinal arch may contribute to increased load on the lateral side of the foot. Thus, these anatomic features may be useful to identify soccer players at high risk of Jones fracture at medical checkup.

Survey on Video-Based Biomechanics and Biometry Tools for Fracture and Injury Assessment in Sports

“…In this work, athletes developed fractures in the fifth metatarsal while performing kicking and cutting movements. Other studies include: plantar pressure influences the risk of injuries [19]; specific action against static motions for detecting discrepancies in lateral foot loadings [20]; plantar forces at the lateral forefoot between healthy and fractured players [21]; more tendency to fracture for the case of a non-preferred foot [22]; explanations regarding static plantar pressure measurements to be not efficient in assessing fatigue injury risks [23]; specific regions within the foot showing higher pressures in the non-preferred feet of football players [24]; longer fifth metatarsal and higher medial longitudinal arch in the case of fractured against healthy players [25], among other studies.…”

Fifth Metatarsal Jones Fractures: Diagnosis and Treatment

“…14 In addition, metatarsus adductus can cause lateral column overload resulting in increased stress at the base of the fifth metatarsal in subsequently a higher risk for fracture. 6,15…”

“…Varus hindfoot alignment increases the forces at the fifth metatarsal base, which may lead to a higher risk for fracture. 5 In addition to cavovarus hindfoot alignment, Fujitaka et al 6 found that a longer proximal tip of the fifth metatarsal may cause greater stress across the fifth metatarsal base due to a longer lever arm. Individuals with metatarsus adductus have been found to be at an increased risk for fracture due to lateral column overload.…”

Return to Play and Player Performance After Foot Fracture in UEFA Soccer Players

“… 3 , 8 , 11 , 35 , 37 Risk factors for foot fracture include common soccer moves such as cutting and lateral shuffling, in addition to bone alignment, high arch structure, and metatarsal length. 7 Without appropriate rehabilitation after foot fracture, athletes carry significant risk of reinjury. 35 While investigators have studied return-to-play (RTP) metrics after foot fracture in the National Basketball Association (NBA) and National Football League (NFL), there is a paucity of information on time to RTP and rates of RTP in elite-level soccer players sustaining these injuries.…”