Headless Compression Screw Fixation of Jones Fractures: An Outcomes Study in Japanese Athletes

Background: Internal fixation is advocated as the primary treatment for fifth metatarsal Jones fractures in athletes; however, screw insertion site discomfort and refracture can occur especially in competitive athletes. The ideal implant has not been determined. Hypothesis: Headless compression screw fixation of proximal fifth metatarsal Jones fractures is an effective treatment approach especially in competitive athletes. Study Design: Case series; Evidence level, 4. Methods: We studied 60 athletes treated surgically with a headless compression screw for fifth metatarsal Jones fractures (mean age, 19 years). The mean follow-up time was 178 weeks. We evaluated the clinical and radiographic outcomes of headless compression screw fixation of Jones fractures. Results: All athletes returned to full activity. The mean time to start running after surgery was 6.3 weeks (range, 3-12.7 weeks), and the mean time to full activity after surgery was 11.2 weeks (range, 6-25 weeks). One athlete suffered a delayed union, which healed uneventfully. One athlete suffered a nonunion and underwent reoperation for a screw exchange to an autogenous bone graft harvested from the iliac crest. No screw breakage was reported. No athlete suffered a refracture or discomfort in the screw insertion site. Conclusion: Headless compression screw fixation of fifth metatarsal Jones fractures provided excellent results, allowing athletes to return to full activity without both screw insertion site irritation and clinical refracture.