A Study About Jones Fractures Fails to Reassure

You need to read this one with both eyes open.

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Editor’s Note: Sometimes at CORRelations, we’ll cover an article we think is likely to cross your desk, but is one whose message we have reservations about. Here’s one. — SSL

What’s the Claim?

A large retrospective study purported to compare time to union between patients treated surgically and those treated nonsurgically for what the authors called “true Jones” fractures of the 5th metatarsal (those at the metaphyseal-diaphyseal junction, which are believed to be at increased risk for delayed union and nonunion). Both groups were said to have healed at 12 to 13 weeks, with no between-group differences in time to union. Overall, 96% of patients in each group eventually healed, again, with no between-group differences in the risk of nonunion. We’ll come back to why I’m hedging on the language here, and why one should not take the authors’ claim that there was “no difference in the delayed union rate between nonoperative and operative management” at face value.

How’s It Stack Up?