Recently, I have read the literature on Jones fractures, and I want to share with you the disease. Many basketball players have stepped on the pit of the bottom of the fifth metatarsal foot, which has greatly affected their careers, including Yao Ming and Jordan. Among them, the classification of Jones fracture in the fifth metatarsal fracture is famous because of Durant. Not all base fractures of the fifth metatarsal are Jones fractures. So what exactly is a Jones fracture? What is the difference between it and other fractures at the base? What is the difference in processing? Let’s come to Kangkang together. 01 Classification of Fifth Metatarsal Fracture Fifth metatarsal bones are divided into head (green area), backbone (yellow area), and base (red area, blue area, light blue area) according to the fracture site. Among them, the basal part is attached by many tendons, and there is a high incidence of fractures, which is most common in foot fractures. Dameron et al. divided the fracture into 3 areas: the picture above (top view of right foot) area Ⅰ (light blue area) metatarsal base trochanteric fracture, mostly avulsion fracture. . Area Ⅱ (blue area) is Jones fracture , Metaphyseal base metaphyseal fractures, mostly transverse fractures, the fracture line can involve the fourth and fifth metatarsal articular surface. Zone III (red zone) fractures of the proximal metacarpal 15mm far from the metaphyseal metaphyseal end, mostly fatigue fractures. According to whether it is a fresh fracture, it is divided into TorgI type, type II, and type III. Among them, type I belongs to fresh fractures with good blood supply, and type II and type III are mostly chronic fatigue fractures or fractures with poor blood supply that are not effective in conservative treatment. The following picture can help you better understand ~ so why should it be so fine? The reason is that for different classifications, we will have different treatment options. (Knock on the blackboard here and highlight the key points ↓↓↓) 02 treatment options I area avulsion fractures will choose conservative treatment, relatively speaking, Jones fractures and fatigue fractures will choose surgical treatment, because the latter two The blood supply is not so good. For the same reason, TorgI type is more inclined to conservative treatment than type II and type III. The above picture can be a good summary of which people are inclined to undergo surgery, and these people in bold black strongly recommend surgery. 03 Injury mechanism Under what circumstances is this type of fracture prone to occur? The base of the fifth metatarsal is relatively fixed during varus and metatarsal flexion, and the third fibula muscle produces a pulling effect on the fifth metatarsal shaft, and generates a shearing force at the junction of the metaphyseal base of the fifth metatarsal base, so the third fibula tendon It is the main pathological structure that causes Jones fractures. 04 Special blood supply characteristics Jones fractures are more difficult to recover than other fifth metatarsal fractures because of their special blood supply characteristics. The blood supply at the base of the fifth metatarsal bone mainly depends on the metaphyseal blood vessels from the joint capsule and the nourishing blood vessels that enter from the middle of the metatarsal shaft. The study found that due to the different sources of blood supply to the base of the fifth metatarsal bone, a relatively avascular area was formed between the metaphyseal vessels and the nourishing vessels. The existence of a relatively avascular area is one of the important reasons that the fracture is not easy to heal after Jones fracture. Moreover, there are many tendons attached to the base, which also has an impact on the rehabilitation here. 05 Rehabilitation process (when weight-bearing, orthosis wearing time, return to exercise time) is different depending on the operation or conservative treatment, and is adjusted under personal tolerance, but it is recommended to return to the field after the fracture line has healed. The following are suggestions from some literatures for your reference only.  . About weight-bearing after surgery-under conservative conditions, it is recommended not to bear weight for 6 weeks. There are also patients who can bear weight for 1-2 weeks. If the physical fitness is good and the operation is perfect, some doctors allow heel weights to be carried out immediately after the operation, but it is forbidden to do forefoot weight-bearing movements (because shear forces are generated and affect the healing of fractures). Regarding the return to sports time-2-4 weeks can return to the game, but the re-break rate is high. After the fracture line is healed, 3-4 months is more appropriate. The average return time is 15.2 weeks.  . Conservative treatment recommends 6-8 weeks of gypsum fixation, a maximum of 12 weeks. Weight-bearing is prohibited during this period, and walking boots will be used after the fracture line has healed. The average time to return to exercise was 26.3 weeks. The more you understand the Jones fracture, the more correct the choice will be. Know thyself, ever-victorious!
Comprehensive foreign media reports that the 20-year-old girl of the United Kingdom, Ellie Jones, had a congenital facial deformity. When she was 8 years old, her chin stopped growing, and her teeth were unevenly arranged. After six years, after undergoing orthodontics and chin reconstruction surgery, the girl’s face became beautiful and moving, and she regained her confidence. She said excitedly: “This changed my life.” Jones began wearing braces at the age of 14, and then her dentist discovered that her chin had not grown since the age of 8. At the age of 16, Jones underwent the first mandibular surgery. She said, “I was only able to eat liquid food that month, it was very painful, and I was unable to speak normally, so I had to write on the notebook.” Here, the dentist and the maxillofacial restoration doctor consulted several times to perform a mandibular restoration operation for Jones, amputating her mandible and implanting it into a new mandible. Emma Woolley, a doctor at Jones, said, “Many people with deformed jaws don’t realize the need for treatment, but just find it difficult to chew. If you don’t treat it in time when you are young, it will really affect your future life.” She said she was very happy to see that surgical treatment changed Jones’s life and made her regain her confidence. Radiographs of the mandible before and after Jones’ surgery. Jones said that before learning to dance often used to be afraid of hands and feet, but after the operation, the dance teacher clearly felt the difference brought by her self-confidence. Jones’ mother said that the surgery not only changed her daughter’s face, but also changed the way she expressed herself, making her a beautiful girl. Currently Jones is a store clerk living with his parents and sister. She said that her confidence has greatly improved after the operation, and she finally feels that she is a normal person. “The painful years are worth it.” Now her dream is to be a photographer to photograph the unique moments of others. She is looking for opportunities to realize her dream.