Jones fracture: who needs surgery, healing time and return to sport

An X-ray has just shown a Jones fracture, and the big question is whether you need surgery. The answer depends on how active you are, how the bone is healing, and exactly where the break sits.

Who benefits from Jones fracture surgery?

Jones fracture surgery usually means passing a screw down the inside of the bone, called intramedullary screw fixation.^[3] It helps most if you fit one of these groups:

• Athletes. A 2021 review of 646 Jones fractures in athletes recommended surgery for every one of them.^[3]
• Highly active people. Surgery may be the first treatment for competitive athletes, people with physically demanding jobs, or anyone for whom slow healing is a concern.^[1]
• Fractures slow to heal. Without surgery, 44% of these went on to heal. With surgery, 97% did.^[4]
• Fractures that have not healed. A screw healed 97% of these.^[4]
• Stress fractures in athletes. Surgery is the usual treatment, because care without surgery has high rates of failed healing and new breaks.^[6]
• Bones that have shifted or broken into several pieces.^[2]

You don’t have to be a pro. A 2026 review of 998 patients found fewer complications with surgery (8.5% versus 15.6%), fewer fractures that failed to heal (3.3% versus 11.6%) and higher foot function scores. Its authors noted that care without surgery can also succeed.^[7]

For a less active person, a boot or cast can be a reasonable first step, as long as you understand the trade-offs.^[8] If the bone doesn’t heal, surgery is often required.^[1]

Jones fracture vs avulsion vs stress fracture: what’s the difference?

Doctors divide the base of the fifth metatarsal into three zones, based on where the break sits against the joint with the fourth metatarsal.^[9]

	Where	How it happens	Usual treatment
Avulsion (“pseudo-Jones”), zone 1	The very base of the bone, before that joint[9]	A tendon or ligament pulls off a small piece as the foot and ankle twist[1]	Boot, cast or stiff shoe; surgery for a large piece that has moved[1,2]
Jones fracture, zone 2	Level with that joint, where blood supply is poor[9,1]	A sudden break or a stress injury[2]	Screw for active people; otherwise a boot or cast
Stress fracture, zones 2 and 3	At or just past that joint[9,6]	Repeated strain; pain builds, often with no single injury[10]	Surgery in athletes; otherwise at least 6 weeks of no weight[6,10]

Avulsion fractures do well without surgery. In one review, 93.2% healed without surgery and 95.1% with it.^[5] Six randomized trials of 403 people found a removable support matched a cast.^[11]

Avulsion and Jones fractures both cause pain, swelling, tenderness and bruising on the outside of the foot, and trouble walking. A Jones fracture can also be missed on a first X-ray, so more imaging may be needed.^[2] Hurt it rolling your ankle? Read sprain or fracture. For slow-building pain, see outside of foot pain and stress fractures in runners.

Jones fracture healing time: screw or boot?

	With a screw	Without surgery
Healed, athletes (review of 22 studies)	97.3%	71.4%
Healed, acute fractures (review of 32 studies)	96.3%	77.4%
Average weeks to heal, athletes	8.2	13.7
Average weeks to heal, acute fractures	9.4	11.0
Returned to play, athletes	98.8%	71.6%
Average weeks to return, athletes	9.6	13.1

Source: two reviews.^[3,5] For a stress fracture here, care without surgery typically means at least six weeks in a cast or boot with no weight on the foot, and sport usually has to wait about 12 weeks.^[10] Even with proper healing, the foot may stay swollen for several months.^[1]

In 222 feet with stress fractures fixed with a screw, 14% had a healing problem, and the risk was higher with a small-diameter screw or no bone graft (added bone at the break).^[12]

The limits. A screw is not risk free. Known problems include wound trouble, nerve injury and irritation from the hardware.^[13] One review called the complication rate of surgery high,^[8] and a 2021 German review advised early functional therapy, which keeps the foot moving, for zone 2 fractures.^[9] Most of the evidence is low level, mainly case series (reports on groups of patients).^[4] A small pilot trial of 18 soccer players with stress fractures found no significant differences between shockwave therapy and a screw, and its authors called for larger studies.^[13]

When can you return to sport after a Jones fracture?

Timelines vary. Return to sport after a screw ranged from 4 to 18 weeks in one review, whose authors warned against going back before imaging shows full healing, because the bone can break again.^[4] Return only once the pain is gone and healing is confirmed, then build up gradually.^[10]

Jones fractures are familiar in pro football. A review of six NFL studies covering 285 fractures found every athlete returned, with average times from 6 to 27 weeks. New breaks after surgery ranged from 4% to 12%.^[14] In one series of 25 NFL players, the nine who could return the same season took 8.7 weeks on average, and three of the 25 broke the bone again and needed more surgery. Those players had an intensive rehab plan with bone stimulators and custom orthotics, so their timeline isn’t a target for everyone.^[15]

ESPN reported on September 17, 2025, that Green Bay Packers receiver Jayden Reed had surgery that week on a Jones fracture in his left foot, after missing most of training camp with it.^[16] On September 30, 2026, Bleacher Report said he would miss the rest of the 2026 season for neck surgery.^[17] That is his status as of that report. We have no connection with Mr. Reed or the team, and we have not examined him.

How we decide

Dr. Efe Ozturk is a Foot and Ankle Surgeon and podiatrist. We examine the foot, take X-rays at the practice, find exactly where the break sits, and talk through your sport, your work and your goals. If you need an operation, it’s handled through our Center for Lower Extremity Surgery (external site). See fracture care and foot and ankle surgery. We see patients in Lyndhurst, Paramus and Millburn, NJ.

Common questions

Can a Jones fracture heal on its own?

Often, but not without treatment. In reviews, about 71% to 77% healed without surgery, so roughly one in four did not.^[3,5]

Can you walk on a Jones fracture?

Stay off the foot until you’re seen, because walking may cause further injury.^[2] After surgery, plans differ. One college sports series let athletes bear weight in a walking boot right away, as tolerated, so follow your own surgeon’s plan.^[18]

Does the screw have to come out?

Most of the time, no.^[10] In that college series, three of 26 screws were taken out for skin irritation, and one bone broke again after a screw came out.^[18]

When to see a Foot and Ankle Surgeon or podiatrist