Koyama Tomoki, Saita Yoshitomo, Tateishi Tomohiko, Tanita Tomokazu, Ukita Hiroki, Shima Toshiro, Itaya Nobuyuki, Yaguchi Haruki, Yamamoto Nanako, Mori Yu, Aizawa Toshimi, Nagao Masashi
Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai, 980-8574, Japan.
Jones Fracture Research Group, Tokyo, 113-8421, Japan.
Asia Pac J Sports Med Arthrosc Rehabil Technol. 2025 Aug 21;42:15-20. doi: 10.1016/j.asmart.2025.08.007. eCollection 2025 Oct.
Jones fractures, stress fractures at the proximal metaphyseal-diaphyseal junction of the fifth metatarsal, are common in sports that involve repetitive jumping and turning, particularly football (i.e., soccer). The incidence among Japanese football players is higher than in Europe, with a high refracture rate, particularly in conservatively managed cases. Although surgical treatment is preferred for athletes, limited data exist on risk factors in youth players. This study aimed to investigate the prevalence and risk factors for Jones fractures among high-level Japanese high school football players through medical examinations.
Medical examinations were conducted during the 2024 tournament involving 20 top-level high school teams (567 players). Ultrasound and X-ray imaging identified fractures, and players underwent various physical tests, including hip internal rotation (HIR) and weight-bearing position during a single heel raise (SHR). A questionnaire collected demographic data and fracture histories. Statistical analyses, including the Wilcoxon signed-rank test and Mann-Whitney test, were conducted to determine associations with fracture risk.
Of 232 male players (40.9 % of all), 18 (7.8 %) tested positive on ultrasound, seven (3.0 %) had confirmed fractures on radiography, and 11 reported a history of Jones fractures. Players with restricted HIR <30° and lateral weight-bearing during SHR showed a significantly higher fracture risk (Crude Odds Ratio: 3.74, p = 0.01). Additional lateral weight bearing during SHR increased the risk (Crude Odds Ratio, 4.02; p = 0.007).
Restricted HIR and lateral weight-bearing during SHR were identified as risk factors for Jones fractures in youth football players. Recognizing these factors may enable targeted preventive measures to reduce injury risk in high-level athletes.
琼斯骨折是第五跖骨近端干骺端-骨干交界处的应力性骨折，在涉及反复跳跃和转身的运动中很常见，尤其是足球（即英式足球）。日本足球运动员的发病率高于欧洲，骨折复发率高，尤其是在保守治疗的病例中。虽然手术治疗是运动员的首选，但关于青少年运动员风险因素的数据有限。本研究旨在通过医学检查调查日本高水平高中足球运动员中琼斯骨折的患病率和风险因素。
在2024年比赛期间对涉及20支顶级高中球队（567名球员）进行了医学检查。超声和X线成像确定骨折情况，球员接受了各种身体测试，包括髋关节内旋（HIR）和单足跟抬起（SHR）时的负重姿势。通过问卷调查收集人口统计学数据和骨折病史。进行了包括Wilcoxon符号秩检验和Mann-Whitney检验在内的统计分析，以确定与骨折风险的关联。
在232名男性球员（占所有球员的40.9%）中，18人（7.8%）超声检查呈阳性，7人（3.0%）X线检查确诊骨折，11人报告有琼斯骨折病史。HIR受限<30°且SHR时向外侧负重的球员骨折风险显著更高（粗优势比：3.74，p = 0.01）。SHR时额外的外侧负重增加了风险（粗优势比，4.02；p = 0.007）。
HIR受限和SHR时向外侧负重被确定为青少年足球运动员琼斯骨折的风险因素。认识到这些因素可能有助于采取有针对性的预防措施，以降低高水平运动员的受伤风险。
