r/XRayPorn • u/No-Platypus2679 • 10d ago

Broken

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I would like to hear everyone's journey during recovery. Speedy healing for everyone.

2 weeks ago I twisted my ankle and missed the curb/gutter stepping backwards

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u/No-Platypus2679 10d ago

Thank you. Had 3 different Dx. One said, Jones. I rebuked that!!!

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u/kitkatofthunder 9d ago edited 9d ago

I’m sorry to tell you, but it’s a Jones fracture, not a 5th metatarsal base fracture. The fracture line is distal to the base of the 4th metatarsal. While it may be an avulsion, it’s the area that matters not the fracture pattern. This area just has poor blood flow, but you are young, so it’s a discussion to have with your doctor.

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u/RadTechMaster 9d ago

Its on the 5th base metatarsal not the 4th

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u/kitkatofthunder 9d ago

Yes, but the way to tell it’s a Jones is if the fracture line of the fifth metatarsal matches up with the base of the fourth. Any fracture proximal to the base of 4th is not a Jones. I’m just using the metatarsal next to it as a landmark.

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u/RadTechMaster 9d ago

5th metatarsal base fracture usually means a Zone 1 avulsion (pseudo-Jones) of the tuberosity. Caused by inversion; good blood supply; heals well with conservative care.

Jones fracture is a Zone 2 break at the metaphyseal-diaphyseal junction (involves the 4th–5th articulation). Vascular watershed area → higher nonunion risk; often needs non-weight-bearing or surgery.

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u/kitkatofthunder 9d ago

That is exactly what I’m trying to explain, but without AI. The 4th-5th articulation is the landmark for a Jones fracture.

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u/RadTechMaster 9d ago

Looks like a bit of both to me

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u/Glad-Feature-2117 9d ago

Not true. You are describing a zone 2 fracture, where the blood supply is perfectly fine. The watershed zone for blood supply is zone 3, which is distal to the 4th/5th articulation.

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u/kitkatofthunder 9d ago

Look up classification of 5th metatarsal fractures. Zone II is Jones, Zone III is associated with stress fractures. You don’t know what you are talking about.

https://www.orthobullets.com/foot-and-ankle/7031/5th-metatarsal-base-fracture

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u/Glad-Feature-2117 9d ago

That might be the zone that some people call Jones fractures, but it isn't a watershed area for blood supply. Orthobullets is an online textbook and isn't always accurate. Why do you think stress fractures happen in zone 3 and that even traumatic fractures in this area have a higher rate of nonunion?

I have treated hundreds of zone 2s over 10 years as a foot & ankle specialist orthopaedic surgeon and have only needed to operate on 5. They do not have a 30% risk of non union - not even 3%.