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Foot & Ankle

Jones Fracture: two different breaks of the same bone.

Fractures at the base of the fifth metatarsal, on the outer side of the foot, come in two types that behave very differently. A true Jones fracture has a poor blood supply and often needs a screw, while a pseudo-Jones avulsion usually heals on its own.

Written bySteven J. Lee, MD · Double Fellowship-Trained · Hand & Sports Medicine
Last reviewed · May 2026

The fifth metatarsal is the long bone on the outer edge of the foot, and its base is a common fracture site, usually from rolling the ankle and foot inward. Two patterns occur close together but behave differently, which is why telling them apart matters.

A pseudo-Jones, or avulsion, fracture is at the very tip of the bone where a tendon pulls off a fragment, and it usually heals on its own. A true Jones fracture sits a bit farther along, in a zone with a poor blood supply, and is prone to slow healing or non-union, so it is treated more aggressively, especially in athletes.

Why the two types differ

The difference is location and blood supply. The avulsion (pseudo-Jones) fragment has a good blood supply and reliably heals with protected weight-bearing. The true Jones fracture sits in a watershed zone with poor blood supply, so it heals slowly and is at real risk of non-union, which is why screw fixation is often chosen, particularly for active patients.

Symptoms

Common findings after rolling the foot include:

  • Pain, swelling, and tenderness on the outer edge of the foot
  • Difficulty bearing weight on the outer foot
  • Bruising along the outer border of the foot
  • An injury easily mistaken for an ankle sprain
Dr. Lee's approach

The first step is identifying which fracture is present, because the two are managed differently. Dr. Lee confirms the pattern on X-ray and treats a pseudo-Jones avulsion with protected weight-bearing, since it reliably heals.

A true Jones fracture is treated based on the patient and the fracture. Non-athletes may be treated with strict non-weight-bearing immobilization, but because of the poor blood supply and non-union risk, screw fixation is often the better choice, especially for athletes who want a more reliable, faster return to sport.

Pseudo-Jones (avulsion) fracture

This fracture at the tip of the bone has a good blood supply and reliably heals with protected weight-bearing in a stiff-soled shoe or boot, followed by a graded return to activity. Surgery is rarely needed.

True Jones fracture

Because it sits in a zone of poor blood supply with a real risk of non-union, a true Jones fracture is treated either with strict non-weight-bearing immobilization or, often, with a screw placed across the fracture. Screw fixation is frequently chosen for athletes for a more reliable, faster return to sport.

Recovery timeline

Recovery depends on the fracture type and treatment:

  1. Pseudo-Jones
    Protected weight-bearing in a boot or stiff-soled shoe, with a graded return over several weeks.
  2. True Jones, non-surgical
    A period of strict non-weight-bearing immobilization, monitored with imaging for healing.
  3. True Jones, after screw fixation
    Protected weight-bearing, then a graded return to sport guided by healing on imaging.

What patients commonly misunderstand

Two things to get straight:

  • Not all fifth-metatarsal fractures are the same. A pseudo-Jones avulsion heals readily; a true Jones fracture has a poor blood supply and a real risk of non-union. Telling them apart is what guides treatment.
  • It is easily mistaken for a sprain. A fracture at the base of the fifth metatarsal can feel like an ankle sprain. Outer-foot pain after rolling the ankle deserves an X-ray.

This page is general educational content authored by Dr. Lee. It is not a substitute for individual medical advice. Every patient's case is different, book a consultation to discuss yours.

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Patient questions

Jones and pseudo-Jones fractures, answered.

  • What is the difference between a Jones and a pseudo-Jones fracture?

    Both are at the base of the fifth metatarsal, but a pseudo-Jones (avulsion) fracture is at the very tip where a tendon pulls off a fragment and has a good blood supply, so it heals reliably. A true Jones fracture sits a bit farther along, in a zone with poor blood supply, so it heals slowly and is at real risk of non-union.

  • Do I need surgery?

    A pseudo-Jones avulsion rarely needs surgery and heals with protected weight-bearing. A true Jones fracture is treated either with strict non-weight-bearing immobilization or with a screw across the fracture. Because of the poor blood supply, screw fixation is often chosen, especially for athletes who want a more reliable, faster return to sport.

  • I thought I just sprained my ankle. Could it be a fracture?

    Yes. A fracture at the base of the fifth metatarsal happens from the same rolling-in mechanism as an ankle sprain and can feel similar. Pain and tenderness on the outer edge of the foot after rolling the ankle deserve an X-ray to tell the two apart.

Next step

Pain on the outer edge of your foot after a roll? The exact break determines the plan.

Fractures at the base of the fifth metatarsal come in two types that heal very differently. A pseudo-Jones avulsion heals on its own, while a true Jones fracture often needs a screw because of its poor blood supply. Telling them apart is the first step.

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