Letter to the Editor
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Apr 18, 2022; 13(4): 408-410
Published online Apr 18, 2022. doi: 10.5312/wjo.v13.i4.408
Existing fixation modalities for Jones type fifth metatarsal fracture fixation pose high rates of complications and nonunion
Albert Thomas Anastasio, Selene G Parekh
Albert Thomas Anastasio, Department of Orthopedic Surgery, Duke University Health System, Durham, NC 27710, United States
Selene G Parekh, Department of Orthopaedic Surgery, Duke University Hospital, Durham, NC 27710, United States
Author contributions: Parekh SG designed research; Anastasio AT wrote the letter; and Parekh SG revised the letter.
Conflict-of-interest statement: Neither author reports any conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Albert Thomas Anastasio, MD, Surgeon, Department of Orthopedic Surgery, Duke University Health System, 2301 Erwin Rd, Durham, NC 27710, United States. albert.anastasio@duke.edu
Received: October 4, 2021
Peer-review started: October 4, 2021
First decision: December 9, 2021
Revised: December 12, 2021
Accepted: March 27, 2022
Article in press: March 27, 2022
Published online: April 18, 2022
Abstract

Jones type fifth metatarsal fractures pose a challenge to the foot and ankle surgeon, given documented high nonunion rates as well as high complication rates including hardware prominence, nerve injury, and screw breakage for existing treatment modalities including screw and plantar plate fixation. We call for the design of innovative Jones-fracture specific implants which contour to the natural curve of the fifth metatarsal. Future research should aim to expand upon existing literature for Jones fracture fixation and evaluate efficacy of novel implants which are designed to address unacceptably high complication rates for existing treatment modalities.

Keywords: Jones, Metatarsal base, Fifth metatarsal, Athlete, Nonunion, Malunion

Core Tip: Jones type fifth metatarsal fractures have high rates of complications and fixation failure. While intramedullary screw fixation is the current accepted treatment modality, we call for innovation in the treatment options for Jones fracture fixation to more appropriately address the challenges seen with this fracture pattern in the high level athlete.