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ABritishsurgeonnamedSirRobertJonessustainedanacutefractureatthebaseofthefifthmetatarsalbonewhiledancing.ThisthenpromptedtheJonesfracturetobenamedafterhim.

一位名叫罗伯特琼斯爵士的英国外科医生在跳舞时第五跖骨底部发生了急性骨折。这促使琼斯骨折以他的名字命名。

Jonesfracturesoccuratthemetaphyseal/diaphysealjunction.Thefractureextendsintotheintermetatarsaljointproximaltothemetatarsocuboidjoint.Theintermetatarsaljointarticulateswiththefourthmetatarsalandthemetatarsocuboidjointarticulateswiththecuboidbone.InorderfortheJonesfracturetobecalledso,thefracturemustentertheintermetatarsaljoint,whichmeansthefracturemustalsobedistaltothemetatarsaocuboidjoint.

琼斯骨折发生在干骺端/骨干端交界处。骨折延伸至跖间关节、跖骰关节、第四跖关节与骰骨。琼斯骨折：骨折必须进入跖间关节，这就意味着骨折也必须累及跖骨关节远端。

Jonesfracturesoccurabout1.5cmdistaltothetuberosityofthefifthmetatarsalbone.Thismetatarsalboneisdividedintothehead,theneck,theshaft,andthetuberosity.Jonesfracturesoftheproximalfifthmetatarsaloccursinthewatershedareawithin1.5cmofthetuberosity.Thismeansthatthefractureoccursinanareaoflimitedbloodsupply.Therearemultiplemetaphysealarteriesinthetuberosity.Thereisalsoanutrientarterywithintramedullarybranchesthatprovidesretrogradebloodflowtotheproximalfifthmetatarsal.Therefore,afracturedistaltothetuberositywilldisruptthenutrientarterysupply,resultinginrelativeavascularity.

琼斯骨折发生在第五跖骨结节远端约1.5厘米处。跖骨分为头、颈、干和结节。第五跖骨近端琼斯骨折发生在距结节1.5cm的分水岭区。这意味着骨折发生在血液供应有限的区域。结节内可见多条干骺动脉，还有一条营养动脉与髓内分支，提供逆向血流到第五跖骨。因此，结节远端骨折会破坏营养动脉供应，导致相对缺血。

Theperoneustertiustendonisinsertedintothedorsalmetaphysisofthefifthmetatarsalbone.Then,theperoneusbrevistendonisinsertedintothetuberosityofthefifthmetatarsalbone.Theplantarfasciaisalsoconnectedtothefifthmetatarsalbone.Therefore,whenaJonesfractureoccurs,thetendonswillpullthefractureapart,whichwillpreventhealing.

第三腓骨肌腱止于第五跖骨背侧干骺端，腓骨短肌腱止于第五跖骨结节。足底筋膜也与第五跖骨相连。因此，当发生琼斯骨折时，肌腱会将骨折拉开移位影响愈合。

Therearethreetypesoffracturesattheproximalfifthmetatarsal.AfractureinzoneIiscalledatuberosityavulsionfracture.AfractureinzoneIIiscalledaJonesfracture.Finally,afractureinzoneIIIisusuallyastressfracture.AfractureinzoneIisalsocalledapseudoJonesfracture.Itislocatedattheperoneusbrevisinsertionsite,andisusuallytreatedwithconservativetreatment.ZoneIIJonesfracturesoccuratthemetaphyseal-diaphysealjunction,andinvolvethefourthandfifthmetatarsalarticulation.ZoneIIIstressfracturesarechronicfracturesthatoccurdistaltothefourthandfifthmetatarsalarticulation,andmaybeassociatedwithcavovarusfootdeformity.

第五跖骨骨折有三种类型。I区骨折称为结节性撕脱骨折。II区的骨折称为琼斯骨折，III区骨折通常为应力骨折。I区的骨折也称为假琼斯裂缝。它位于腓骨短肌止点部位，通常采用保守治疗。II区Jones骨折发生于干骺端-骨干交界处，累及第四和第五跖关节。III区应力性骨折是发生在第四和第五跖骨关节远端的慢性骨折，可能与足部的高弓外翻足畸形有关。

Itisimportanttonotmakethewrongdiagnosisoftheproximalfifthmetatarsalbaseinchildrenwhilelookingatanormalgrowthplate.Thisisusuallypresentbetweentheagesof9–14yearsofageandisparallelandlateraltothemetatarsal.

重要的是不要对儿童近端第五跖骨基底部正常生长板做出错误的诊断。这种情况通常发生在9-14岁之间，与跖骨平行或稍侧。

X-rayswillshowthefractureanditslocation.AnacuteJonesFracturewillhavesharpmarginswithnointramedullarysclerosis.Ontheotherhand,astressfracturewillhaveawidefracturelinewithmedullarysclerosis.

X线能显示骨折及其位置。急性琼斯骨折边缘锐利，无髓内硬化。另外，应力性骨折在髓质硬化时骨折线较宽。