Conservative Treatment with Continuous Cryotherapy as a Japanese Judo Therapy for Jones Fracture: A Case Report

Abstract

Introduction: Cryotherapy has been widely used as an acute treatment for traumatic injuries. However, it is rarely continuously used for fracture treatment for several weeks, particularly for refractory fractures. Some judo therapists, who can treat traumatic injuries under the Japanese law, use cryotherapy as a continuous treatment for fractures. Herein, we report a case of Jones fracture (refractory) treated by a therapist using continuous cryotherapy. Case presentation: A 49-year-old woman had a non-transposable Jones fracture located at the metaphysis of the right 5th metatarsal from an inversion injury in the ankle. At this time, the patient had severe pain and swelling, and her walking ability was impaired. Three days after the fracture, the therapist started conservative treatment mainly using cryotherapy for the lesion part for 15 min thrice every day; splint-fixation using a hard cardboard was then performed using the standard style of the Japanese Judo therapy. Fifteen days after the fracture, the numerical rating scale (NRS) score of the patient notably decreased to 1.5 compared with the first NRS score of 10. Moreover, pain upon normal walking with full-weight bearing completely resolved, and the ankle had a full range of motion. Moreover, there was no muscle atrophy. Twenty-four days after the fracture following daily cryotherapy, the NRS score was 0, and there were no problems in the performance of activities of daily living and work. Moreover, mild running and going up and down the stairs became possible. Finally, the patient showed excellent clinical and functional results at the two-month and one-week follow-up, and the side effects of this therapy were not observed. Conclusion: This case highlights the use of cryotherapy as a continuous treatment for Jones fracture.