Jones fracture of the fifth metatarsal: Is operative intervention justified? A systematic review of the literature and meta-analysis of results.
BACKGROUND
This study assesses the outcomes of surgical vs. conservative management in the treatment of the Jones fracture.


METHODS
A systematic review using four databases from their inception until September 2014 was undertaken. Six studies were found evaluating operative therapy compared to conservative treatment.


RESULTS
Six relevant studies were included, with a total of 237 patients. Of these, 51% were treated non-operatively, and 49% had surgical intervention. Those in the non-operative group were found to have a significantly higher odds ratio (OR) of fracture non-union (OR 5.74, 95% confidence interval (CI) 2.65-12.40, P<0.001). Studies also reported a prolonged healing time and a longer time to return to sports. Of the trials with time to union as an outcome measure, 3 of 4 trials found favourable results in the operative cohort.


CONCLUSIONS
Surgical intervention is recommended for patients presenting with a Jones fracture as it is found to result in a lesser non-union rate and an improved time to union.
Graduate Entry Medical School, University of Limerick, Limerick, Ireland.
Jeffrey
J
Yates
Midlands Regional Hospital, Tullamore, Co Offaly, Ireland. Electronic address: iainfeeley@rcsi.ie.
Iain
I
Feeley
Graduate Entry Medical School, University of Limerick, Limerick, Ireland.
Sanskriti
S
Sasikumar
Graduate Entry Medical School, University of Limerick, Limerick, Ireland.
Gurender
G
Rattan
Graduate Entry Medical School, University of Limerick, Limerick, Ireland.
Ailish
A
Hannigan
Midlands Regional Hospital, Tullamore, Co Offaly, Ireland.
Eoin
E
Sheehan
D001265:Athletic Injuries / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing; D015775:Fractures, Stress / Q000601:surgery*; D006801:Humans; D008682:Metatarsal Bones / Q000293:injuries / Q000601:surgery*
Conservative; Jones fracture; Management; Nonunion; Surgical; Time to union