Acute Jones fractures are routinely treated operatively. A 1 cm skin incision is made just proximal to the base of the fifth metatarsal. A guide pin for a cannulated drill is inserted down the medullary canal. It is critical to check the AP lateral and oblique radiograph to make sure that the guide pin is centered perfectly within the medullary canal. Failure to obtain ideal placement could result in penetration of the medial cortex. Once the guide pin has been adequately positioned, a drill is placed over the guide pin using the soft tissue protector and the medullary canal is reamed to an appropriate diameter. I generally use a 6.5mm solid Synthes screw. After the canal has been drilled, it is imperative to use the tap that corresponds with the appropriate screw. The tap must be placed all the way to the end of where the screw will be inserted. A 6.5 mm short thread Synthes screw is ideal and provides excellent compression.