Jones fractures are Zone 2 fractures of the fifth metatarsal. Biomechanical comparisons of fixation strategies for Jones fractures remain limited by the lack of standardized, head-to-head evaluations across major fixation methods. The purpose of this study was to perform a standardized biomechanical comparison of six fixation configurations representing the three primary surgical techniques for Jones fractures and to examine the mechanical factors underlying differences in early construct stability. A synthetic fifth metatarsal model with a simulated Zone 2 fracture was stabilized using lateral plate fixation with different screw configurations, Kirschner wire fixation with or without tension-band wiring, or intramedullary headless screw fixation. All constructs were tested under displacement-controlled cantilever bending, and the force required to reach 1 mm of fracture site displacement was obtained and construct stiffness was calculated. Plate-based fixation demonstrated the highest resistance to bending deformation, followed by intramedullary screw fixation, whereas Kirschner wire-based constructs exhibited the lowest stability. These differences were explained by variations in load-sharing pathways and effective working length among fixation constructs. The addition of tension-band wiring did not result in a measurable improvement in stability compared with Kirschner wire fixation alone, consistent with the dependence of tension-band mechanisms on active muscle loading not represented in the experimental model. These findings provide a unified biomechanical comparison of commonly used fixation constructs for Jones fractures and clarify the mechanical basis for differences in early construct stability.
Shih et al. (Fri,) studied this question.