Jones fractures in elite athletes-2025 International Foot and Ankle Sports Consensus and systematic review
Abstract
Purpose: Jones fractures are complex injuries with highly variable treatment paradigms. This study aims to establish an expert consensus with support from a systematic review to guide management of Jones fractures in elite athletes.
Methods: A consensus process was conducted using a modified Delphi technique with two rounds of questionnaires. Consensus was defined as 75%-85% agreement, strong consensus as 86%-99% agreement, and unanimous consensus as 100% agreement. In addition, a systematic review was conducted to evaluate nonoperative versus operative management of Jones fractures in athletes.
Results: Of 37 total consensus statements, 15 achieved unanimous consensus, 21 achieved strong consensus, and 1 reached consensus. The systematic review included 27 studies consisting of 1056 patients. The majority of fractures with a stress aetiology were treated with open reduction internal fixation (86.4%), with a mean return to sport time of 13.3 ± 4.5 weeks and a complication rate of 8.4%. Treatment failure was highest for stress fractures that were treated nonoperatively (8.2%). Traumatic Jones fractures were treated surgically in 62.7% of cases, with the remaining 37.3% managed conservatively. All patients with traumatic fractures successfully returned to sport at an average of 11.6 ± 2.2 weeks regardless of treatment modality. Treatment failure following traumatic fractures was highest for those treated conservatively (16.1%).
Conclusions: The average time to return to sport…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,056 participants or records.
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