手术-jones骨折(第5跖骨基底骨折)切开复位内固定术

Jonesmann骨折指第五跖干骺端与骨干连接部骨折。

英国骨科医生Sir Robert Jones（1857–1933）自己跳舞后发生此类骨折并首先描述，故此得名。

Jones fractures occur in a small area of the fifth metatarsal that receives less blood and is therefore more prone to difficulties in healing. A Jones fracture can be either a stress fracture (a tiny hairline break that occurs over time) or an acute (sudden) break. Jones fractures are caused by overuse, repetitive stress, or trauma. They are less common and more difficult to treat than avulsion fractures.

A Jones fracture is a fracture of the diaphysis of the fifth metatarsal of the foot. The fifth metatarsal is at the base of the small toe. The proximal end, where the Jones fracture occurs, is in the midportion of the foot. Patients who sustain a Jones fracture have pain over this area,swelling, and difficulty walking. The fracture was first described by British orthopedic

surgeon Sir Robert Jones, who sustained this injury himself while dancing, in the Annals of Surgery in 1902.

Fractures of the fifth metatarsal of the foot are surprisingly controversial among radiologists, particularly concerning proximal metatarsal fractures. Some term these fractures Jones fractures, others dancers fractures, while others simply term them proximal metatarsal fractures. According to Orthopedic Radiology (Adam Greenspan, 3rd edition), a "true Jones" fracture occurs one inch distal to the base of the fifth metatarsal. It is not due to peroneus brevis tendon avulsion but rather a twisting inversion injury to the foot. Greenspan states that more proximal injuries are frequently misinterpreted as Jones fractures but really are avulsion fractures by the peroneus brevis tendon. These latter fractures heal quickly, while more distal fractures may undergo fibrous union only.

A patient stepped off a curb and sustained a fracture of the proximal aspect of the fifth metatarsal. According to Greenspan, this would be termed a "true Jones fracture."

In contradistinction, this patient sustained a fracture of the proximal aspect of the fifth metatarsal. Greenspan terms this an avulsion injury.In an avulsion fracture, a small piece of bone is pulled off the main portion of the bone by a tendon or ligament. This type of fracture is the result of an injury in which the ankle rolls. Avulsion fractures are often overlooked when they occur with an ankle sprain.

Treatment：

If a Jones fracture is not significantly displaced, it can be treated with a cast, splint or walking boot for four to eight weeks. Patients should not place weight on the foot until instructed by their doctor. Three-fourths of fractures treated like this should heal.

In the case of acute fracture in an athlete, a dynamic compression plate can be placed on the tension side of the fracture, K-Wire with Monofiament wire in a figure 8 fashion due to the nature of a transverse fracture. Internal fixation with cortical or cancellous screw would require an oblique fracture that could be addressed through "The rule of 2's" in regards to Internal fixation with screws. Other treatments commonly encouraged are increased intake of vitamin

D and calcium.

This injury must be differentiated from the physiologic

developmental apophysis commonly and normally occurring at this site in adolescents. Differentiation is possible by characteristics such as absence of sclerosis of the fractured edges (in acute cases) and orientation of the lucent