Screw Diameter and Healing Outcomes in Jones Fractures: A Scoping Review

Authors

Merlin Sajeev, The University of Texas Rio Grande ValleyFollow
Jessica Sima, The University of Texas Rio Grande ValleyFollow
Srilalitha Lanka, The University of Texas Rio Grande ValleyFollow
Amanda Killeen, The University of Texas Rio Grande ValleyFollow

Document Type

Poster

Publication Date

Fall 9-26-2025

Abstract

Introduction: Jones fractures occur at the metaphyseal–diaphyseal junction of the fifth metatarsal and are prone to delayed or nonunion due to limited perfusion and high mechanical stress. Intramedullary (IM) screw fixation is the standard operative treatment, yielding higher union rates than conservative management. There is no clear consensus on the influence of screw size on healing outcomes.

Aim: To examine the impact of IM screw diameter on union rates in Jones fracture fixation.

Methods: A literature search was conducted using Google Scholar and PubMed with the search term: “"Screw" AND "Diameter" AND "Union" AND "Jones Fractures"”. Articles published between 2015 and 2025 in English, Mandarin, Malayalam, Telugu, and Hindi languages that assessed union rate associated with different IM screw diameters were included in the review. A total of 333 articles were identified. After screening for relevance, 3 studies were selected for qualitative analysis.

Results: Three studies with 267 subjects aged 21.6 years were included. Six reported union rates ranging from 86% to 100%. Smaller cohorts with 4mm, 5.5mm and 6.5mm screws (n=6–24) showed 100% union rates but with wide CIs. In contrast, the larger cohort with 6.5mm screws (n=222) showed 86% union rates with narrower CIs.

Conclusions: Our review suggests that both small and large-diameter screws can achieve high union rates in Jones fracture fixation, with larger cohorts confirming consistent outcomes. Although 4.0mm and 5.5mm screws achieved 100% union in limited studies, their wide confidence intervals highlight the uncertainty of these findings, limiting generalizability. Many included studies were retrospective or case-based, and patient cohorts varied in age, comorbidities, and activity levels, which may influence outcomes. Thus, more prospective research is needed to confirm optimal screw selection and evaluate long-term functional outcomes such as return-to-play and complication rates.

Recommended Citation

Sajeev, Merlin; Sima, Jessica; Lanka, Srilalitha; and Killeen, Amanda, "Screw Diameter and Healing Outcomes in Jones Fractures: A Scoping Review" (2025). School of Podiatric Medicine - Student Research. 22.
https://scholarworks.utrgv.edu/sopm_mspub/22