Journal of Foot and Ankle Surgery - 2026-04-22 - Journal Article; Review
Screw Characteristics and Intramedullary Fixation for the Jones Fractures and associated Outcomes: A Systematic Review and Meta-Analysis.
Lowe D, Grambart S, Cheng CI, Adelman V, Adelman R
Topics
Key Takeaway
Neither screw diameter nor cannulated vs. solid screw type significantly affects return-to-play timing or complication rates in intramedullary fixation of Jones fractures across 8 studies.
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Summary
This systematic review and meta-analysis searched four databases (2000–2023) to determine whether screw diameter or screw type (cannulated vs. solid) influences outcomes after intramedullary fixation of Jones fractures. Eight studies were included, and pooled analysis found no statistically significant difference in return-to-play weeks or complication rates across screw diameter comparisons. Similarly, cannulated and solid screw constructs produced equivalent complication profiles.
Key Limitation
The aggregate patient sample is drawn predominantly from retrospective studies with heterogeneous outcome definitions and likely underpowered individual cohorts, making the null findings potentially a reflection of insufficient statistical power rather than true equivalence.
Original Abstract
OBJECTIVE
A Jones fracture is a common injury in foot and ankle care. Open reduction internal fixation (ORIF) versus conservative treatment has a strong literature background supporting ORIF for the active patients. Standard treatment for fixation of the Jones fracture is intramedullary screw fixation. However, there is limited research on how screw characteristics influence outcomes. This systematic review aimed to compare the outcomes based on screw characteristics in the treatment of Jones fractures.
METHODS
A search of the Cochrane, EBSCO, Scopus, and PubMed databases from 2000 to 2023 identified six retrospective studies, one prospective study, and one case series that evaluated outcomes of intramedullary screw fixation in Jones fractures.
RESULTS
The analysis found no statistically significant difference in return-to-play (RTP) weeks or complication rates when comparing different screw diameters. Additionally, there was no significant difference in complication rates between cannulated and solid screw fixation.
CONCLUSIONS
In treating Jones fractures with intramedullary screw fixation, neither screw diameter nor screw type (cannulated or solid) appears to impact complication rates or RTP outcomes. Further studies, particularly randomized controlled trials with larger sample sizes, are needed to confirm these findings and achieve greater homogeneity.