• 1.

    Jones R: I. Fracture of the base of the fifth metatarsal bone by ındirect violence. Ann Surg 35: 697, 1902.

  • 2.

    Dameron TB: Fractures and anatomical variations of the proximal portion of the fifth metatarsal. J Bone Joint Surg 57: 788, 1975.

  • 3.

    Lareau CR, Hsu AR, Anderson RB: Return to play in national football league players after operative jones fracture treatment. Foot Ankle Int 37: 8, 2016.

  • 4.

    Tu LA, Knapik DM, Sheehan J, et al: Prevalence of Jones fracture repair and impact on short‐term NFL participation. Foot Ankle Int 39: 6, 2018.

  • 5.

    Portland G, Kelikian A, Kodros S: Acute surgical management of Jones’ fractures. Foot Ankle Int 24: 829, 2003.

  • 6.

    Japjec M, Starešinić M, Starjački M, et al: Treatment of proximal fifth metatarsal bone fractures in athletes. Injury 46: S134, 2015.

  • 7.

    Wright RW, Fischer DA, Shively RA, et al: Refracture of proximal fifth metatarsal (Jones) fracture after intramedullary screw fixation in athletes. Am J Sports Med 28: 732, 2000.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Roche AJ, Calder JD: Treatment and return to sport following a Jones fracture of the fifth metatarsal: a systematic review. Knee Surg Sports Traumatol Arthrosc 21: 1307, 2013.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Lee TH, Lee JH, Chay SW, et al: Comparison of clinical and radiologic outcomes between non-operative and operative treatment in 5th metatarsal base fractures (Zone 1). Injury 47: 1789, 2016.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Hunt KJ, Reiter MJ, Axibal DP, et al: Management of fifth metatarsal fracture and refracture in athletes. Operative Techniques in Orthopaedics 28: 61, 2018.

  • 11.

    Sarimo J, Rantanen J, Orava S, et al: Tension-band wiring for fractures of the fifth metatarsal located in the junction of the proximal metaphysis and diaphysis. Am J Sports Med 34: 476, 2006.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Duplantier NL, Mitchell RJ, Zambrano S, et al: A biomechanical comparison of fifth metatarsal jones fracture fixation methods. Am J Sports Med 46: 1220, 2018.

  • 13.

    Huh J, Glisson RR, Matsumoto T, Easley ME: Biomechanical comparison of ıntramedullary screw versus low-profile plate fixation of a jones fracture. Foot Ankle Int 37: 411, 2016.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Willegger M, Benca E, Hirtler L, et al: Evaluation of two types of ıntramedullary jones fracture fixation in a cyclic and ultimate load model. J Orthop Res 38: 911, 2020.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Ahn JK, Chung HJ, Bae SY, et al: Treatment of fifth metatarsal base fracture using tension band wiring. J Korean Foot Ankle Soc 15: 18, 2011.

  • 16.

    Nolte P, Anderson R, Strauss E, et al: Heal rate of metatarsal fractures: A propensity-matching study of patients treated with low-intensity pulsed ultrasound (LIPUS) vs. surgical and other treatments. Injury 47: 2584, 2016.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Kim J, Kim JW, Lee JI, et al: Surgical treatment of the fifth metatarsal base fracture using multiple Kirschner wires. J Korean Foot Ankle Soc 18: 24, 2014.

  • 18.

    Thomas JL, Davis BC: Three-wire fixation technique for displaced fifth metatarsal base fractures. J Foot Ankle Surg 50: 776, 2011.

  • 19.

    Nagao M, Saita Y, Kameda S, et al: Headless compression screw fixation of Jones fractures: an outcomes study in Japanese athletes. Am J Sports Med 40: 2578, 2012.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Murawski CD, Kennedy JG: Percutaneous internal fixation of proximal fifth metatarsal jones fractures (Zones II and III) with Charlotte Carolina screw and bone marrow aspirate concentrate: an outcome study in athletes. Am J Sports Med 39: 1295, 2011.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    O’Malley M, DeSandis B, Allen A, et al: Operative treatment of fifth metatarsal jones fractures (Zones II and III) in the NBA. Foot Ankle Int 37: 488, 2016.

  • 22.

    Porter DA, Duncan M, Meyer SJ: Fifth metatarsal Jones fracture fixation with a 4.5-mm cannulated stainless steel screw in the competitive and recreational athlete: a clinical and radiographic evaluation. Am J Sports Med 33: 726, 2005.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Lehman RC, Torg JS, Pavlov H, et al: Fractures of the base of the fifth metatarsal distal to the tuberosity: a review. Foot Ankle 7: 245, 1987.

  • 24.

    Kavanaugh JH, Brower TD, Mann RV: The Jones fracture revisited. J Bone Joint Surg Am 60: 776, 1978.

  • 25.

    Larson CM, Almekinders LC, Taft TN, et al: Intramedullary screw fixation of Jones fractures. Analysis of failure. Am J Sports Med 30: 55, 2002.

  • 26.

    Granata JD, Berlet GC, Philbin TM, et al: Failed surgical management of acute proximal fifth metatarsal (Jones) fractures: a retrospective case series and literatüre review. Foot Ankle Spec 8: 454, 2015.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Kelly IP, Glisson RR, Fink C, et al: Intramedullary screw fixation of Jones fractures. Foot Ankle Int 22: 585, 2001.

  • 28.

    Pietropaoli MP, Wnorowski DC, Werner FW, et al: Intramedullary screw fixation of Jones fractures: a biomechanical study. Foot Ankle Int 20: 560, 1999.

  • 29.

    Husain ZS, DeFronzo DJ: Relative stability of tension band versus two-cortex screw fixation for treating fifth metatarsal base avulsion fractures. J Foot Ankle Surg 39: 89, 2000.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Husain ZS, DeFronzo DJ: A comparison of bicortical and intramedullary screw fixations of Jones’ fractures. J Foot Ankle Surg 41: 146, 2002.

  • 31.

    Mahajan V, Chung HW, Suh JS: Fractures of the proximal fifth metatarsal: percutaneous bicortical fixation. Clin Orthop Surg 3: 140, 2011.

  • 32.

    Kim JB, Song IS, Park BS, et al: Comparison of the outcomes between headless cannulated screw fixation and fixation using a locking compression distal ulna hook plate in fracture of fifth metatarsal base. J Foot Ankle Surg 56: 713, 2017.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Suh JS, Kim JH, Choi JY: Operative treatment of fractures of the fifth metatarsal base. J Korean Foot Ankle Soc 12: 189, 2008.

  • 34.

    Moshirfar A, Campbell JT, Molloy S, et al: Fifth metatarsal tuberosity fracture fixation: a biomechanical study. Foot Ankle Int 24: 630, 2003.

  • 35.

    Lee YS, Lee JY, Park SS, et al: A comparison of bicortical and ıntramedullary screw fixations in Jones’ fractures using finite element analysis-preliminary report. Korean J Sports Med 32: 79, 2014.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36.

    Unthan M, Graul I, Hallbauer J, et al: Biomechanical comparison of cannulated screw osteosynthesis with tension-band wiring for proximal fractures of the fifth metatarsal (Jones fracture). J Foot Ankle Surg 62: 300, 2023.

    • PubMed
    • Search Google Scholar
    • Export Citation

Comparison of Bicortical Headless Cannulated Screw Fixations, Tension Band Fixations, and Kirschner Wire Fixations of a Jones Fracture: A Biomechanical Study

Onur Yilmaz Çanakkale Mehmet Akif Ersoy State Hospital, Orthopedics and Traumatology, Çanakkale, Turkey.

Search for other papers by Onur Yilmaz in
Current site
Google Scholar
PubMed
Close
 MD
,
İbrahim Mutlu Kocaeli University, Faculty of Technology Kocaeli, Turkey.

Search for other papers by İbrahim Mutlu in
Current site
Google Scholar
PubMed
Close
 PhD
,
Tolgahan Kuru Canakkale Onsekiz Mart University Medical Faculty, Department of Orthopedics and Traumatology, Çanakkale, Turkey.

Search for other papers by Tolgahan Kuru in
Current site
Google Scholar
PubMed
Close
 MD
,
Ali Bilge Canakkale Onsekiz Mart University Medical Faculty, Department of Orthopedics and Traumatology, Çanakkale, Turkey.

Search for other papers by Ali Bilge in
Current site
Google Scholar
PubMed
Close
 MD
,
Berna Güngör Canakkale Onsekiz Mart University Medical Faculty, Department of Orthopedics and Traumatology, Çanakkale, Turkey.

Search for other papers by Berna Güngör in
Current site
Google Scholar
PubMed
Close
 MD
,
Hasan Kizilay Bolu Gerede State Hospital, Orthopedics and Traumatology, Bolu, Turkey.

Search for other papers by Hasan Kizilay in
Current site
Google Scholar
PubMed
Close
 MD
,
Hacı Olcar Bozok University Medical Faculty, Department of Orthopedics and Traumatology, Yozgat, Turkey.

Search for other papers by Hacı Olcar in
Current site
Google Scholar
PubMed
Close
 MD
,
Recai Özkılıç Bolu İzzet Baysal State Hospital, Orthopedics and Traumatology, Bolu, Turkey.

Search for other papers by Recai Özkılıç in
Current site
Google Scholar
PubMed
Close
 MD
, and
H. Yener Erken Canakkale Onsekiz Mart University Medical Faculty, Department of Orthopedics and Traumatology, Çanakkale, Turkey.

Search for other papers by H. Yener Erken in
Current site
Google Scholar
PubMed
Close
 MD

Background: The aim of study was to biomechanically compare the fixation of Jones fracture using headless cannulated screw, tension band, and two Kirschner wires.

Methods: A total of 60 fourth-generation, fifth metatarsal synthetic bone models were divided into three groups according to the fixation techniques. A vertical load, oriented from plantar to dorsal and lateral to medial, was applied to the metatarsal specimen that were potted with molding material. The stiffness and fatigue values were compared between the three fixation groups.

Results: In the plantar to dorsal load test, the stiffness values were found to be significantly higher in Group 1 compared to the other groups (P = .034, P = .013). No significant difference was found in the analysis in terms of fatigue values in plantar to dorsal load testing (P = .348, P = .416). No significant difference was found between compression screw and tension band groups in lateral to medial loading test, in terms of stiffness and fatigue values (P = .096, P = .762). However, the stiffness values and fatigue values of these two groups were found to be statistically significantly higher than the Kirschner wire group (P = .003, P = .002, P = .016, P = .023).

Conclusions: The result of this study showed that the bicortical fixation of headless compression screw provides a more stable fixation than other fixation methods, especially in plantar to dorsal loading.

Corresponding author: Onur Yilmaz, MD, Çanakkale Mehmet Akif Ersoy State Hospital, Hamidiye, Rauf Denktaş Cd No:17, 17100 Kepez/Çanakkale Merkez, Çanakkale, Turkey. (E-mail: onurylmz52@gmail.com)
Save