• Masashi Nagao, Yoshitomo Saita, So Kameda, Hiroaki Seto, Ryo Sadatsuki, Yuji Takazawa, Masafumi Yoshimura, Yukihiro Aoba, Hiroshi Ikeda, Kazuo Kaneko, Masahiko Nozawa, and Sung-Gon Kim.
• Department of Orthopedic Surgery, Juntendo University Nerima Hospital, Tokyo, Japan. nagao@juntendo.ac.jp
• Am J Sports Med. 2012 Nov 1; 40 (11): 2578-82.

BackgroundInternal 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.HypothesisHeadless compression screw fixation of proximal fifth metatarsal Jones fractures is an effective treatment approach especially in competitive athletes.Study DesignCase series; Evidence level, 4.MethodsWe 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.ResultsAll 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.ConclusionHeadless 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.

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