A Jones fracture is a break in the fifth metatarsal — the long bone on the outer edge of the foot that connects to the pinky toe — occurring in a specific zone near the base of the bone where blood supply is limited. That limited blood flow is exactly why Jones fractures are treated more cautiously than other metatarsal breaks: they heal more slowly and are more prone to complications if not managed correctly from the start.
Outer midfoot pain after a rolled ankle or a period of repetitive impact is easy to write off as a sprain. But because a Jones fracture needs a different treatment approach than a simple sprain or a more common avulsion fracture, getting an accurate diagnosis early makes a real difference in how well — and how quickly — it heals.
What exactly is a Jones fracture?
The fifth metatarsal runs along the outside of the foot, and a Jones fracture is a break that occurs in the bone's shaft, near its base, running transverse (crosswise) to the bone rather than at an angle. This location is important: it sits in a "watershed" area with relatively poor blood supply compared to the rest of the bone, which is why Jones fractures heal more slowly than fractures elsewhere on the fifth metatarsal and carry a higher risk of the bone failing to heal properly (nonunion) if treatment is delayed or inadequate.
What causes a Jones fracture?
Jones fractures generally happen in one of two ways:
- Repetitive stress: Ongoing impact and loading, common in running-intensive sports, can create small stress fractures in the bone that eventually progress to a complete break if the activity continues without rest.
- Acute trauma: A sudden inversion injury — the kind of ankle roll where the foot turns outward and the ankle rolls in — can place a sudden, concentrated load on the fifth metatarsal and fracture it outright.
Because both mechanisms are common in sports, athletes in running- and cutting-heavy activities such as basketball, soccer, and football are at elevated risk. People with naturally high arches are also more vulnerable, since a high arch shifts more pressure to the outer edge of the foot with every step.
What are the symptoms of a Jones fracture?
Symptoms can range from subtle to severe, especially early on, which is part of why Jones fractures are sometimes mistaken for a bad sprain. Watch for:
- Pain and tenderness along the outer midfoot, worsened by pressure
- Swelling over the outside of the foot
- Bruising along the outer edge of the foot
- Difficulty or inability to bear weight on the foot
- A dull, chronic ache in the outer midfoot that doesn't resolve with rest, in the case of a stress-related fracture
- Tingling or numbness in more significant injuries
Severe bruising, marked numbness, or fever alongside foot pain warrants prompt evaluation, as these can point to a more serious injury or complication.
How is a Jones fracture diagnosed?
Diagnosis starts with a conversation about how the injury happened and a physical exam that includes targeted pressure over the fifth metatarsal to pinpoint the area of pain. X-rays confirm the fracture and its exact location, which matters because treatment differs for a Jones fracture versus other fifth metatarsal breaks. In some cases, especially stress fractures that may not show clearly on an initial X-ray, additional imaging such as a CT or MRI scan may be needed for a definitive diagnosis.
How is a Jones fracture treated?
Because of the bone's limited blood supply in this area, Jones fractures are treated more conservatively — and sometimes more aggressively — than other metatarsal fractures:
- Non-weight-bearing casting or a walking boot: Many Jones fractures are treated with a period of strict non-weight-bearing immobilization to give the bone the best chance to heal without disruption.
- Surgery: Because of the higher risk of nonunion, surgery — typically placement of a screw down the length of the bone — is often recommended for displaced fractures, for athletes who need a faster and more reliable return to activity, or for fractures that fail to heal with casting alone.
Healing generally takes about six to eight weeks with appropriate treatment, though it can take considerably longer if the fracture is treated conservatively or if healing is slow. Your podiatrist will use follow-up X-rays to confirm the bone is healing before clearing you to return to full weight-bearing and activity.
When should I see a podiatrist?
Any outer midfoot pain following a twisting injury or a fall — especially if you can't put weight on the foot — should be evaluated promptly rather than treated as a routine sprain. The same goes for a nagging outer-foot ache that develops gradually during a running or training season and doesn't improve with rest. Because a missed or delayed Jones fracture diagnosis can lead to a longer, more complicated recovery, it's always worth having persistent outer-foot pain checked out. You can request an appointment at either of our Northern Utah offices.
Medically reviewed by the physicians at Wasatch Foot & Ankle Institute. Our board-certified, fellowship-trained podiatrists provide foot and ankle care in Farmington and South Ogden, Utah. This article is for general education and is not a substitute for an in-person evaluation.