A frequent malady of summer activity is a sprained ankle, which sports-medicine experts from the American College of Foot and Ankle Surgeons (ACFAS) said today is by far the most neglected injury in the U.S. They warn that many who disregard a sprain and forego medical treatment are risking more serious damage, as persistent pain and swelling from an ankle sprain also may indicate a frequently undiagnosed break on the outside of the foot, known as a Jones fracture.
�Both avid and weekend athletes are vulnerable to ankle sprains and Jones fractures because of the force they can exert on their feet, especially in sports like basketball and tennis,� said Marco A. Vargas, DPM, FACFAS, a Texas-based foot and ankle surgeon. �Unfortunately, many think they should play with pain and continue their sports activities. Therefore, their first inclination is to self treat an ankle sprain. But if the pain and swelling haven’t improved in several days, the injury must be evaluated by a foot and ankle surgeon to determine if a Jones fracture has occurred.�
When someone with a sprained ankle hobbles into the emergency room, the attending staff focuses on the obvious problem and frequently will miss a Jones fracture because standard ankle x-rays do not show it. During the exam, the outside of the foot should be palpated, and the clinician will know right away if there is a Jones fracture because the patient will feel severe pain. The area is very hot to the touch.
Jones fractures too often fail to heal quickly or correctly because the pain is attributed to the coincident ankle sprain. Therefore, the fracture goes untreated and worsens until the ankle is better and attention is directed to the still painful foot. The consequences of self diagnosis are serious because sprains and fractures are treated differently, and a Jones fracture can become a chronic painful condition if it doesn’t heal properly. �Of all the bones you could break in your foot, you don’t want a Jones fracture.� said Vargas. He added that it also can result from severe trauma to the foot.
Jones fractures are located where the elongated bone behind the little toe gets its blood supply and, when the break happens, the tendon on the outside of the ankle pulls apart the bone fragments. �This injury can disrupt circulation as well as cause unwanted motion at the fracture site, which makes it difficult for the bone to heal,� Vargas explained. �If you continue to walk or run with a Jones fracture, the tendon will keep pulling and separating the bone fragments. Subsequent repair could require a bone graft from the hip and months on crutches.�
Treatment for Jones fractures usually depends on the age and activity level of the patient and on the degree of bone-fragment separation that results. �Minimally invasive surgery using fluoroscopy with internal or external fixation normally is recommended for young, athletic patients with Jones fractures,� said Vargas. Older, less active patients with slight fragment separation may benefit from immobilization and keeping weight off the foot. It can take six to 10 weeks for a Jones fracture to heal.
Vargas advised that a foot and ankle surgeon should evaluate all severe ankle sprains. �Any ankle injury accompanied by immediate swelling and bruising should be looked at right away,� he said.
For further information about foot and ankle fractures and to locate a foot and ankle surgeon in your area, visit www.FootPhysicians.com, the ACFAS patient education Web site.
Marco A. Vargas DPM
Foot & Ankle Associates
Board Certified in Podiatric Surgery
17510 W Grand Parkway South
Suite 530
Sugar Land, TX 77479
(281) 313-0090
(281) 232-7918 Fax
[email protected]
www.drvargas.com