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Fifth metatarsal fracture (Jones fracture) rehab protocol

General considerations

  • Patient will be walking with crutches non-weightbearing until most of the swelling resolves.
  • Patient may be in a removable boot after surgery for a week or two at the direction of the physician.
  • Limit unnecessary walking or standing for the first week to control swelling and pain.
  • Ice ankle/foot 3-5 times (15 minutes each time) per day to control swelling and inflammation.
  • Elevate leg above the heart as much as possible to control swelling and inflammation.
  • No impact or cutting exercises/activities for 6 weeks post-op.
  • M.D. follow-up visits at Day 1, Day 8-10, Month 1, Month 6 and Year 1 post-op.

Weeks 1:

  • M.D. visit at day 1 post-op to change dressing and review home program.
  • Start gentle ankle active range of motion immediately post-op.
  • M.D. visit at day 8-10 for suture removal and check-up.
  • Gait training with crutches to minimize compensations and to reinforce weightbearing status on the surgical leg as necessary.

Exercises:

  • Toe curls and toe spreads
  • Quad-sets with straight-leg raises
  • Gluteal sets
  • Well-leg biking
  • Upper body training

Weeks 2- 6:

  • Progress to weightbearing as tolerated with assistive device as needed guided by pain and swelling and the physical therapist.
  • Follow-up x-ray at week 4-6 to monitor healing.
  • Soft tissue treatments for swelling, mobility and healing.
  • Exercises: Bike, core exercises, balance activities when indicated.
  • Foot and ankle stretching and theraband exercises to regain full ROM and strength.

Weeks 6 - 8:

  • Increase functional weight bearing exercises and activities. Avoid jumping and rapid changes in direction.
  • Continue with foot and ankle joint mobilizations.

Week 8 and beyond:

  • Start sport-specific training.
  • Increase the intensity of strength, balance, coordination and functional training for gradual return to activities and sports.
  • Return to specific sports is determined by the physical therapist through functional testing specific to the targeted sport.
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Kevin R. Stone · Jonathan R. Pelsis · Scott T. Surrette · Ann W. Walgenbach · Thomas J. Turek 

Stone, K.R., Pelsis J.R., Adelson W.S., Walgenbach, A.W. 2010.

Stone K.R., A.W. Walgenbach, A. Freyer. 2008.