» Percutaneous fixation of Jones fractures with an intramedullary screw is the standard of care for athletes, who experience unacceptably high rates of nonunion, refracture, and delayed return to activities with nonoperative treatment.

» Fixation should use the largest solid partially threaded screw, usually 5.5 or 6.5 mm in diameter, that can be inserted without displacing or comminuting the fracture.

» Autogenous bone graft should be used to supplement intramedullary fixation in cases of nonunion, refracture, and implant failure.

» An understanding of risk factors for refracture and nonunion, including cavus and/or varus foot alignment and nutritional and hormonal deficiency, is critical.

» Return to normal walking or sport activities is dependent on clinical and radiographic healing. Computed tomography (CT) can be especially helpful as a confirmatory test in elite athletes, but may not be necessary or cost-effective in non-athletes.