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Jones Fracture--How long should I wait for healing before resorting to surgery?

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  #1  
Old 22nd February 2011, 11:13 PM
iwant2wheels iwant2wheels is offline
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Default Jones Fracture--How long should I wait for healing before resorting to surgery?

I was diagnosed with a Jone's Fracture (complete break, no displacement) about 10 weeks ago. I was in a cast, NWB with crutches for 6 weeks. I used an ultrasonic bone stimulator for 20 minutes, once a day. X-ray showed no healing, but no displacement. Dr. had me then wear a Cam Walker and use crutches for 3 more weeks, gradually adding weight to the bad foot. By the end of the 3 week period, I could stand on the foot (1/2 my body weight), and walk with some weight added to the foot. During this 3 week period, I increased use of bone stimulator to twice daily (I would have done this earlier, but Dr. didn't tell me to until now). My foot was feeling pretty good at this point. Went in for x-rays, which showed callous formation--fuzziness at break site. Dr. was very positive about results, but did note that he would have liked to have seen more healing at the lateral side of the bone, where the break still appeared sharply defined. However, much to my happy surprise, he said I was ready to start walking, full weight bearing, without the boot, and begin PT. I questioned this, since I expected to continue with Cam Walker, and to gradually work up to full weight bearing over a couple weeks or so. Nonetheless, I was very excited, and eager to get on with my normal life. I walked a little that first day. Second day, I actually drove and ran a few errands, shopping, etc. for an hour or so, and was fine. But after the third day (1 hr. in am slow walking/standing, 1 hr. in pm slow walking/standing), my foot took a definate turn for the worse, with pain at the fracture site. I went back to boot and crutches the following day (yesterday), but pain still persists today.

Should one expect some pain, and if so how much, when beginning walking after weeks of NWB? Could I have possibly damaged the callous forming in my metatarsal? Or is the pain more likely in the soft tissue? What is a reasonable period of time to wait for healing before resorting to surgery? My fear is that although my bone shows healing, this process will slow down and/or stop, and the bone will never completely heal. I really don't want surgery, but I don't want to agonize for weeks on crutches just to have to go through it all over again after surgery. Also, is it safe to drive (my break is in my right foot)? I hadn't been driving until I was allowed full weight bearing without the boot. But the doc thought it would be ok to take off the boot to drive, then to put the boot back on after. Any advice or information would be very appreciated.

Thanks!
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Old 24th February 2011, 01:57 PM
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Default Re: Jones Fracture--How long should I wait for healing before resorting to surgery?

i have been dealing with this jones fx since october 23. i was recently told to start trying to transition out of my boot over the next few weeks. sometimes it feels great and other times i can tell it is still not healed. my fracture is still visable on xray. my doc and i don't want to do surgery, but i don't want to feel like i have to baby my foot... i am young and very active! i am giving it this one last month and then seriously discussing my long term outcome with my doc!
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Old 24th February 2011, 02:38 PM
iwant2wheels iwant2wheels is offline
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Default Re: Jones Fracture--How long should I wait for healing before resorting to surgery?

My doctor told me that an X-ray will show the break even a year after injury. He said that X-rays lag behind actual healing, and that how the foot feels--relative pain, etc. is a more accurate indication of healing. Did you break your left or right foot? Are you driving? Did your doctor discuss the possibility that your pain might be in the soft tissue surrounding the break, and not in the bone itself? That's what I'm struggling with now. I wonder if my pain is due to the soft tissue stretching and straining from walking after having been NWB for so long. And even when I first broke my bone, it was never terribly painful, so I have trouble trying to compare my pain before and after. How are you transitioning out of the boot? Did the doctor give you specific directions as to how long you should spend walking or standing on your bad foot each day? Or how much weight to put on it? Are you using a bone stimulator? Have you gone to a physical therapist? Have you considered getting a second opinion from a different doctor? Is you current doctor a specialist in foot surgery?

I know I've bombarded you with lots of questions. Although I'm sorry you're also suffering with this horrible injury (and 2 months longer than I have!), I'm relieved to have made contact with someone going through the same experience. Thanks for responding, and please let me know how you progress!
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Old 3rd September 2011, 09:13 PM
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Default Re: Jones Fracture--How long should I wait for healing before resorting to surgery?

I am in a similar boat -- Jones fracture on June 26, 2011. I was non weight bearing in a CAM walker for 6 1/2 weeks. At that time, I was told I had enough healing on August 11th to bear weight, get off crutches, and wean myself from my CAM walker to a stiff-soled show. On about day two of walking in my boot, the fracture site started aching. I called the Dr. and was told to go back on crutches. I see the Dr. in a few days to get another X-ray and see if healing is progressing. Even on crutches, I can tell the site is still somewhat sore -- periodic twinges of achiness from pressure by the boot. Like you, I worry that after over 10 weeks I will be told my option is surgery. I'm going a little nuts being off my feet for so long and losing an entire summer of activity. I've never broken a bone, and don't know if some level of achiness is to be expected even when healing is going well.
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Old 3rd September 2011, 09:45 PM
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Default Re: Jones Fracture--How long should I wait for healing before resorting to surgery?

I have good news. I didn't need surgery. However, almost 8 months after the break, I still am quite conscious of my injury. Although I'm going about life as normal, my foot does ache at times. Earlier in the summer, after a stumble off my deck, my foot hurt for a couple weeks. I resolved to always wearing shoes with my prescription insole. This lasted a few weeks, until the soreness let up and the weather got hot, and I couldn't stand closed shoes around the house! But I survived the summer--wearing the special insoles outside the home and exercising. The doctor said to expect periods of soreness for a full year after the break. If your doc doesn't suggest prescription insoles, ASK FOR THEM!! I read about them on this site, and am so thankful. The extra support really does allow you to be on your feet much longer without getting sore.

I will never forget the agonizing weeks of being in a cast, then CAM walker, and months on crutches this past winter. I appreciate my feet more than ever before.

Good luck healing. And don't let all the scary stories get you down--it is possible to heal with conservative methods.
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Old 4th September 2011, 09:06 PM
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Default Re: Jones Fracture--How long should I wait for healing before resorting to surgery?

i suffered a jones fracture on august 15 after missing a step and landing badly on my left foot.

my doctor gave me 2 options: wear a cast for 3 months and see if it heals on its own. if it doesn't heal then we'd do surgery. OR do surgery and in 2.5 weeks i'd already be able to start putting weight on my foot with a boot and be off crutches 4-6 weeks after surgery.

i opted for surgery for 2 reasons: i don't want to waste so much time waiting for it to heal and if it doesn't heal then i'd have to have surgery anyway and waste even more time. also, the chance of reinjury via cast method is ~25% whereas the chance of reinjury via surgery is almost 0 (according to my doc).

the surgery itself is a very minor surgery. it took about 45 minutes and they didn't even have to give me full anesthesia. they just sedated me and gave me local anesthesia on my foot. the incision was very small and they just put a screw in to hold the bones in place. i was in the hospital for 1-2 hours after surgery and then was allowed to go home. the surgery really is not a big deal at all and saves a lot of time, anguish, and suffering in my opinion. i'd recommend surgery.

it has been a little over a week since my surgery. i am in a walking boot now non-weight bearing, but will be able to start putting weight on it by next week.
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Old 5th September 2011, 02:25 AM
iwant2wheels iwant2wheels is offline
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Default Re: Jones Fracture--How long should I wait for healing before resorting to surgery?

I'm glad I took the time to let my foot heal naturally. After reading many first-hand experiences on the internet (many on this forum), I learned that surgery is not a sure thing. I didn't find information suggesting that the surgery route is less likely to result in refracture than taking the conservative approach. However, it was very stressful enduring the agony of a cast and crutches and CAM walker, all the while not knowing whether I'd need to go through it all again if I needed surgery! Also, one needs to keep in mind that not everyone who goes the conservative route actually follows their doctor's orders, uses a bone stimulator, gradually and cautiously returns to FWB, is conscientious with physical therapy, etc...
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Old 30th October 2011, 09:19 PM
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Default Re: Jones Fracture--How long should I wait for healing before resorting to surgery?

I fractured my metatarsal on July 5th. Started using bone stimulator a month ago and Dr. said its starting to heal. Your supposed to use the stimulator for 8 hours a day. You use it at night while you sleep. I see him in 5 weeks to see how much more its healed and to see if I may need surgery. According to my Dr. he said that it is a slow slow process because the area doesn't have a great blood flow.
Good Luck
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Old 1st December 2011, 11:23 PM
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Cool Re: Jones Fracture--How long should I wait for healing before resorting to surgery?

I had surgery yesterday and am in quite a bit of pain which is normal I hear. You mention that you will start to be able to put weight on in the second week. How much weight did you put on? Did you go straight to shoes? Or to a walking boot or what

Thank you
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