{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T19:20:04Z","timestamp":1790796004564,"version":"4.1.0"},"reference-count":32,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2015,9,9]],"date-time":"2015-09-09T00:00:00Z","timestamp":1441756800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot Ankle Int."],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Jones fractures commonly occur in professional athletes and operative treatment remains the standard of care in this patient population. In our clinical experience, an aggressive postoperative rehabilitation protocol for National Football League (NFL) players with an average return to play (RTP) between 8 and 10 weeks can have successful outcomes with few complications. The purpose of this study was to quantify RTP and rate of complications, including nonunion, refracture, and reoperation among a cohort of NFL players with operatively treated Jones fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Between 2004 and 2014, 25 consecutive NFL players who underwent acute Jones fracture fixation by a single surgeon were reviewed. Operative treatment for the majority of patients involved fixation with a Jones-specific intramedullary screw and iliac crest bone marrow aspirate with demineralized bone matrix injected at the fracture site. Additionally, our protocol involved the use of noninvasive bone stimulators, application of customized orthoses, and an aggressive patient-specific rehabilitation protocol. Patient demographics were recorded along with position played, seasons played after surgery, RTP, and complications. RTP was defined as the ability to play in a single regular-season NFL game after surgery. At the time of surgery, average age for all patients was 24.0 years and BMI 31.0.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Player positions included 8 wide receivers, 4 linebackers, 4 tight ends, 2 defensive tackles, 2 cornerbacks, 1 offensive tackle, 1 center, 1 tackle, 1 defensive end, and 1 quarterback. Seventy-six percent of players underwent operative fixation during their first 3 seasons. Forty-eight percent were diagnosed before or during their rookie (first) season. RTP was 100% for all players and 80% were still playing at time of publication. Three patients (12.0%) refractured and required revision surgery. Time until RTP was influenced by other variables and difficult to measure because many surgeries were performed early in the offseason. All 9 players who underwent surgery between July and October, and were therefore eligible to return to play in the same season, had an average RTP of 8.7 weeks (range 5.9-13.6).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>With an appropriately placed intramedullary screw and an aggressive rehabilitation protocol, early RTP was achievable with a low refracture rate in professional athletes. All NFL players in this series were able to return to play after surgery. We observed that these injuries were more likely to occur in the first 3 seasons of play and in wide receivers, linebackers, and tight ends. This at-risk subset of players may benefit from improved preventative measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level IV, retrospective case series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1071100715603983","type":"journal-article","created":{"date-parts":[[2015,9,9]],"date-time":"2015-09-09T23:43:44Z","timestamp":1441842224000},"page":"8-16","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":81,"title":["Return to Play in National Football League Players After Operative Jones Fracture Treatment"],"prefix":"10.1177","volume":"37","author":[{"given":"Craig R.","family":"Lareau","sequence":"first","affiliation":[{"name":"OrthoCarolina Foot & Ankle Institute, Charlotte, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew R.","family":"Hsu","sequence":"additional","affiliation":[{"name":"OrthoCarolina Foot & Ankle Institute, Charlotte, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert B.","family":"Anderson","sequence":"additional","affiliation":[{"name":"OrthoCarolina Foot & Ankle Institute, Charlotte, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2015,9,9]]},"reference":[{"key":"bibr1-1071100715603983","doi-asserted-by":"crossref","unstructured":"Aune KT, Andrews JR, Dugas JR, Cain ELJr. Return to play after partial lateral meniscectomy in national football league athletes. Am J Sports Med. 2014;42:1865-1872. http:\/\/dx.doi.org\/10.1177\/0363546514535069","DOI":"10.1177\/0363546514535069"},{"key":"bibr2-1071100715603983","doi-asserted-by":"crossref","unstructured":"Carreira DS, Sandilands SM. Radiographic factors and effect of fifth metatarsal Jones and diaphyseal stress fractures on participation in the NFL. Foot Ankle Int. 2013;34(4):518-522. http:\/\/dx.doi.org\/10.1177\/1071100713477616","DOI":"10.1177\/1071100713477616"},{"key":"bibr3-1071100715603983","doi-asserted-by":"crossref","unstructured":"Chuckpaiwong B, Queen RM, Easley ME, Nunley JA. Distinguishing Jones and proximal diaphyseal fractures of the fifth metatarsal. Clin Orthop Relat Res. 2008;466:1966-1970. http:\/\/dx.doi.org\/10.1007\/s11999-008-0222-7","DOI":"10.1007\/s11999-008-0222-7"},{"key":"bibr4-1071100715603983","first-page":"238","volume":"315","author":"Clapper MF","year":"1995","journal-title":"Clin Orthop Relat Res"},{"key":"bibr5-1071100715603983","doi-asserted-by":"publisher","DOI":"10.1177\/036354658301100513"},{"key":"bibr6-1071100715603983","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200907000-00006"},{"key":"bibr7-1071100715603983","doi-asserted-by":"crossref","unstructured":"Ekstrand J, van Dijk CN. Fifth metatarsal fractures among male professional footballers: a potential career-ending disease. Br J Sports Med. 2013;47:754-758. http:\/\/dx.doi.org\/10.1136\/bjsports-2012-092096.","DOI":"10.1136\/bjsports-2012-092096"},{"key":"bibr8-1071100715603983","doi-asserted-by":"publisher","DOI":"10.1177\/107110079601700803"},{"key":"bibr9-1071100715603983","doi-asserted-by":"crossref","unstructured":"Hernigou P, Poignard A, Beaujean F, Rouard H. Percutaneous autologous bone-marrow grafting for nonunions. Influence of the number and concentration of progenitor cells. J Bone Joint Surg Am. 2005;87:1430-1437. http:\/\/dx.doi.org\/10.2106\/JBJS.D.02215.","DOI":"10.2106\/00004623-200507000-00003"},{"key":"bibr10-1071100715603983","doi-asserted-by":"crossref","unstructured":"Hernigou P, Poignard A, Manicom O, Mathieu G, Rouard H. The use of percutaneous autologous bone marrow transplantation in nonunion and avascular necrosis of bone. J Bone Joint Surg British. 2005;87(7):896-902. http:\/\/dx.doi.org\/10.1302\/0301-620X.87B7.16289.","DOI":"10.1302\/0301-620X.87B7.16289"},{"key":"bibr11-1071100715603983","doi-asserted-by":"crossref","unstructured":"Hunt KJ, Anderson RB: Treatment of Jones fracture nonunions and refractures in the elite athlete: outcomes of intramedullary screw fixation with bone grafting. Am J Sports Med. 2011;39:1948-1954. http:\/\/dx.doi.org\/10.1177\/0363546511408868.","DOI":"10.1177\/0363546511408868"},{"key":"bibr12-1071100715603983","first-page":"697","volume":"35","author":"Jones R. I.","year":"1902","journal-title":"Ann Surg"},{"key":"bibr13-1071100715603983","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197860060-00008"},{"key":"bibr14-1071100715603983","doi-asserted-by":"publisher","DOI":"10.1177\/107110079301400610"},{"key":"bibr15-1071100715603983","doi-asserted-by":"crossref","unstructured":"Lee KT, Park YU, Jegal H, Factors associated with recurrent fifth metatarsal stress fracture. Foot Ankle Int. 2013;34(12):1645-1653. http:\/\/dx.doi.org\/10.1177\/1071100713507903.","DOI":"10.1177\/1071100713507903"},{"key":"bibr16-1071100715603983","doi-asserted-by":"crossref","unstructured":"Lee KT, Park YU, Jegal H, Prognostic classification of fifth metatarsal stress fracture using plantar gap. Foot Ankle Int. 2013;34(5):691-696. http:\/\/dx.doi.org\/10.1177\/1071100713475349.","DOI":"10.1177\/1071100713475349"},{"key":"bibr17-1071100715603983","doi-asserted-by":"crossref","unstructured":"Metzl J, Olson K, Davis WH, A clinical and radiographic comparison of two hardware systems used to treat jones fracture of the fifth metatarsal. Foot Ankle Int. 2013;34(7):956-961. http:\/\/dx.doi.org\/10.1177\/1071100713483100.","DOI":"10.1177\/1071100713483100"},{"key":"bibr18-1071100715603983","doi-asserted-by":"publisher","DOI":"10.1177\/036354659302100514"},{"key":"bibr19-1071100715603983","doi-asserted-by":"crossref","unstructured":"Mologne TS, Lundeen JM, Clapper MF, O\u2019Brien TJ. Early screw fixation versus casting in the treatment of acute Jones fractures. Am J Sports Med. 2005;33:970-975. http:\/\/dx.doi.org\/10.1177\/0363546504272262.","DOI":"10.1177\/0363546504272262"},{"key":"bibr20-1071100715603983","doi-asserted-by":"crossref","unstructured":"Murawski CD, Kennedy JG. Percutaneous internal fixation of proximal fifth metatarsal jones fractures (Zones II and III) with Charlotte Carolina screw and bone marrow aspirate concentrate: an outcome study in athletes. Am J Sports Med. 2011;39:1295-1301. http:\/\/dx.doi.org\/10.1177\/0363546510393306.","DOI":"10.1177\/0363546510393306"},{"key":"bibr21-1071100715603983","doi-asserted-by":"crossref","unstructured":"Nagao M, Saita Y, Kameda S, et al, Headless compression screw fixation of jones fractures: an outcomes study in Japanese athletes. Am J Sports Med. 2012;40:2578-2582. http:\/\/dx.doi.org\/10.1177\/0363546512459460.","DOI":"10.1177\/0363546512459460"},{"key":"bibr22-1071100715603983","doi-asserted-by":"crossref","unstructured":"Nunley JA, Glisson RR. A new option for intramedullary fixation of Jones fractures: the Charlotte Carolina Jones Fracture System. Foot Ankle Int. 2008;29(12):1216-1221. http:\/\/dx.doi.org\/10.3113\/FAI.2008.1216.","DOI":"10.3113\/FAI.2008.1216"},{"key":"bibr23-1071100715603983","doi-asserted-by":"crossref","unstructured":"Ochenjele G, Ho B, Switaj PJ, Radiographic study of the fifth metatarsal for optimal intramedullary screw fixation of jones fracture. Foot Ankle Int. 2015;36(3):293-301. http:\/\/dx.doi.org\/10.1177\/1071100714553467.","DOI":"10.1177\/1071100714553467"},{"key":"bibr24-1071100715603983","doi-asserted-by":"crossref","unstructured":"Orr JD, Glisson RR, Nunley JA. Jones fracture fixation: a biomechanical comparison of partially threaded screws versus tapered variable pitch screws. Am J Sports Med. 2012;40:691-698. http:\/\/dx.doi.org\/10.1177\/0363546511428870.","DOI":"10.1177\/0363546511428870"},{"key":"bibr25-1071100715603983","doi-asserted-by":"crossref","unstructured":"Porter DA, Duncan M, Meyer SJ. 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