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Injury Risk of Jones Fracture in Soccer Players on Simple X-Ray Images

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Objectives: * Jones fracture is a commonly encountered fatigue fracture among soccer players and can be difficult to treat. Several risk factors have been reported, including restricted internal hip rotation and playing on artificial turf; however, limited reports have associated anatomical characteristics as possible risk factors. Based on the hypothesis that a longer fifth metatarsal length is a risk factor for Jones fractures, this study aimed to determine the radiological characteristics of Jones fractures, particularly the metatarsal bone length ratio. Methods: * This study reviewed cases of soccer players who underwent surgical treatment for their first Jones fracture between April 2006 and December 2021. Those with preoperative simple radiographic imaging of the frontal aspect of the foot were included in the study. Metatarsal lengths were measured for all participants. To reduce potential distortions caused by variations in imaging distance and scale, we calculated the ratio of the fifth metatarsal length to the length of each metatarsal within the same image. Metatarsal length measurements were taken from the distal end of each metatarsal bone to the Lisfranc joint surface using simple frontal radiographic imaging. As a control group, the metatarsal length of members from a professional soccer club was also measured using frontal foot radiographs during medical checkups supported by our hospital. Results: * In total, 82 soccer players with Jones fractures were included in the study, with a mean age at the time of injury of 18.9 years. Additionally, 10 players were studied, with a mean age of 19.4 years, serving as the control group. The ratios of each metatarsal bone were significantly higher in the Jones fracture group when compared to the control group: M5/1 (mean 1.26: mean 1.18, p<0.05), M5/2 (mean 1.02: mean 0.93, p<0.05), M5/3 (mean 1.03: mean 0.98, p<0.05), M5/4 (mean 1.02: mean 1.00, p<0. 05). These differences were statistically significant, indicating that the Jones fracture group exhibited significantly longer metatarsal lengths, particularly in the fifth metatarsal. Conclusions: * Our findings suggest that a longer fifth metatarsal bone may be a potential risk factor for the occurrence of Jones fractures among soccer players.

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Yuto Nakamura

ESSKA Continuous Professional Education Partners