Clinical Outcomes and Complications of Surgical and Conservative Treatment for Jones Fractures: A Systematic Review.

In 30 seconds

This systematic review compared surgical fixation with conservative management for zone 2 fifth metatarsal (Jones) fractures. Ten studies involving 998 patients were included: 211 underwent surgery and 787 received conservative treatment. Surgery was associated with fewer total complications (8.5% vs 15.6%; P = 0.02) and fewer nonunions (3.3% vs 11.6%; P = 0.04). Mean American Orthopaedic Foot and Ankle Society scores at final follow-up were also higher after surgery (96.5 vs 84.1; P = 0.005). The authors noted that conservative treatment can also be successful.

Key findings

• Total complications occurred in 8.5% of surgical patients versus 15.6% of conservatively treated patients (P = 0.02).
• Nonunion rates were 3.3% after surgery and 11.6% with conservative management (P = 0.04).
• Mean American Orthopaedic Foot and Ankle Society scores at final follow-up were 96.5 after surgery versus 84.1 after conservative treatment (P = 0.005).

Why it matters

Jones fracture management lacks clear guidelines, and treatment has often depended on surgeon preference. This review brings together comparative evidence suggesting better complication and patient-reported outcome results with surgery, while also recognizing conservative care as a successful option. These findings help frame the trade-offs clinicians may discuss when considering management.

What to keep in mind

The review included nonrandomized controlled studies, so differences between treatment groups may reflect factors other than treatment. The abstract does not report follow-up duration.