Jones fractures can happen to anyone, but they are especially common in athletes such as football, basketball, or soccer players who twist, change directions, or jump while running. This involves surgically placing a plate that contours over the injury. Long Beach, CA 90806, Copyright 2022 Advanced Foot Care Advice |. When this happens, recovery time for a Jones fracture could go up to twenty weeks. Frozen shoulder is a painful and debilitating problem that can immobilize your shoulder joint for months or even years on end. A Jones fracture may be acutea break that happens suddenlyor it could be a stress fracture, which occurs gradually over time from repeated stress on the bone. Find tutorials, the user guide, answers to common questions, and help from the community forum. In cases where a full recovery in the desired timeframe is unlikely with immobilization alone, a care provider may recommend surgery. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Nonsurgical treatment consisted of the application of either a plaster cast or an elastic bandage. Im now able to walk in most shoes with (usually) minimal pain. Most individuals are able to return gradually to normal activity within about six weeks. It is considered to be a common foot injury, and can gradually happen from excessive repeated motion, or possibly from a sudden injury. Jones fractures can be slow to heal, and there is a risk of reinjury. Above: An X-ray image of a Jones fracture. The fracture may be a complete break in the bone, or it may be a thin crack in the bone. After surgery to repair a Jones fracture, a reduction in weight-bearing activities on the foot is required for proper healing. Symptoms include swelling and pain at the injured area. WebJones fracture surgery is considered a safe procedure, but it is not without risks. These fractures are usually, but incorrectly diagnosed as apophysis. Others may be able to use non-weight bearing medical boots. There were 27 acute fractures and 39 chronic, or stress, fractures. In a Jones fracture, it is 90. If X-rays do not show healing in six weeks, then surgical treatment should be considered. Surgery patients are required to have a COVID-19 test before surgery, according to the pre-surgery packet you received. To return to normal activity, you will be given a rehabilitation plan that includes stretches and strengthening exercises. Your surgeon will realign (set) your bones to their correct position and then secure them in place so they can heal and grow back together. for professional medical advice, diagnoses or treatments. At this point, you should not put weight or exert any pressure on the affected foot until allowed by the doctor. Foot Ankle Orthop. As of today, 8/30, I am 5-1/2 wks. J Foot Ankle Surg. Recovery takes around eight weeks whether or not you've had surgery. The most common method for surgery involves placing a single surgical bone screw to hold the bone fragments together. Iowa City, IA 52242 Autologous bone grafting has been effective in the treatment of Jones fracture nonunion; however, in addition to the morbidity associated with harvesting the graft, the possibility of disruption of the blood supply in this watershed area exists 1, 12, 13. Some people may experience pain before the fracture occurs. Surgery for a Jones Fracture . Yes, you can wait. FOIA It may take longer to heal than other fractures, which may be a Prescott suffered a compound fracture and dislocation of his right ankle in the fifth game of the 2020 season against the New York Giants. However, footwork plays a significant role in athletic performance, which is crucial for almost every sport. If you need medical advice, use the ". In some situations, surgery is required. In apophysis, the metatarsal axis is parallel. Jones fracture is a common type of metatarsal fracture. Non 1999 May 1;59(9):2516-22. The recovery time for a surgical repair is shorter on average but still varies widely. During a bone graft, the damaged bone is removed and replaced with a graft, which is secured with a screw. Studies suggest that non-surgical treatment methods work successfully between 77% and 93% of the time depending on the exact fracture location. One of these is the fracture occurring at an area that doesnt get enough blood supply, reducing the chances of a quick and successful healing process. Follow your healthcare provider's instructions on how to walk safely while allowing your fracture to heal. to the area and the amount of force placed on this part of the foot. Treatment and recoveryFirst aid. As soon as pain occurs, a person can perform the RICE method to reduce pain and swelling. Support. A person may need to wear a foot support for several weeks while a Jones fracture heals. Surgery. Bookshelf Jones fractures are usually classified as acute injuries an injury that is suddenly sustained sometimes due to improper landing on the outside of the foot. 2840 Long Beach Blvd, The content of FootCareMD, including text, images, and graphics, is for informational purposes only. Jones fractures produce pain, swelling, bruising, and difficulty walking. By clicking Accept All Cookies, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. But we have also seen, first-hand, what can happen when a patient shortcuts or otherwise circumvents an experts healing recommendations. As orthopaedic surgeons who specialize in sports medicine, we understand that three-to-fourth month recovery time frames can seem like lifetimes to athletes. Each metatarsal bone is comprised of a base, shaft, neck, and head. In addition Clinical Therapeutics features updates on specific topics collated by expert Topic Long Beach, CA 90806, Memorial Medical Center Orthop J Sports Med. However, when fractures were treated with a surgical procedure involving the placement of a screw in the bone, 97% healed completely. This involves a period of immobilization in a non-weightbearing cast or boot. Jones type fifth metatarsal fracture fixation in athletes: a review and current concept, Fifth metatarsal fractures: an update on management, complications, and outcomes, Fifth metatarsal fractures and current treatment, Heal rate of metatarsal fractures: A propensity-matching study of patients treated with low-intensity pulsed ultrasound (LIPUS) vs. surgical and other treatments, Fifth metatarsal jones fracture: care instructions, Participating in activities where you may experience sudden injuries, such as sports, Engaging in activities that involve long-term, low grade stress on the outside parts of your feet, Playing sports that involve a lot of pivoting movement, like basketball, Having an awareness of your increased risk may help you be more mindful of your general posture and movement, Wearing braces that protect the front, outer part of your feet, Will ask you questions about your pain and the injury in general, Will examine your foot visually and may press on certain parts of it. A Jones fracture, also called a fifth metatarsal fracture, is a break near the base of the long metatarsal bone on the outside of the foot. The primary treatment was surgical for one third of the injuries and nonsurgical for the others. The goals of surgery are to stabilize the fracture and restore anatomy if alterations occurred. Below: An X-ray image of a repaired Jones fracture after surgery. Ice can be used to reduce swelling and over-the-counter medicine to relieve pain. Fractures of the fifth metatarsal. If youve been told you have sustained a Jones fracture, be sure to follow your trusted orthopaedic surgeons recommendations. WebUsually a Jones fracture can heal without the need for surgery. The official source for NFL news, video highlights, fantasy football, game-day coverage, schedules, stats, scores and more. Arch Trauma Res. WebThere were 27 acute fractures and 39 chronic, or stress, fractures. This can be achieved by inserting a screw into the shaft of the bone or applying a plate with screws to the metatarsal. and space open menus and escape closes them as well. American Orthopaedic Foot & Ankle Society, The American Orthopaedic Foot & Ankle Society (AOFAS) offers information on this site as an educational service. All Rights Reserved. It is considered to be a common foot injury, and can gradually happen from excessive repeated motion, or possibly from a sudden injury. Taking regular doses of Vitamin D and calcium can also speed up the healing of the injury. When you have a Jones fracture, you will likely feel a sharp pain on the outside of your foot that makes walking very difficult. Cardiopulmonary resuscitation (CPR), has also WebThe latest Lifestyle | Daily Life news, tips, opinion and advice from The Sydney Morning Herald covering life and relationships, beauty, fashion, health & wellbeing This type of break may result from either an acute injury or repetitive stress. The challenge with Jones fractures is that the fracture occurs within a segment of bone that is considered less vascular, which ultimately means prolonged healing times. Tab will move on to the next part of the site rather than go through menu items. Possible complications of a Jones fracture may include: The majority of individuals have good outcomes whether treated surgically or non-surgically. Those with high-arched feet especially are at risk for a Jones fracture because they put more pressure on the outside of their feet. 2022;7(1):13-25. doi:10.1530/EOR-21-0025, Bowes J, Buckley R. Fifth metatarsal fractures and current treatment. MeSH Additionally, some surgeons allow for protected walking after surgery for Jones fractures. The surgeon has inserted a screw to stabilize the fracture while it heals. Especially for athletes, clearance to play is given once the bone is fully healed. Surgery for a Jones Fracture . Jones Fractures Identified at the National Football League Scouting Combine: Assessment of Prognostic Factors, Computed Tomography Findings, and Initial Career Performance. post-op & was told at my last appt. These factors must be addressed in order to promote fracture healing and bone health in the future. Symptoms typically include pain at the site of the break and a decreased ability to move the affected arm. When a Jones fracture occurs, the foot may bruise and swell, and it will be painful to put weight on it. eCollection 2021 Jan. PLoS One. WebJones Fracture Rehabilitation Protocol. I broke my foot on 6/20 & had my surgery on 7/21. World J Orthop. If the bone doesn't heal within six weeks, surgery may be necessary. Medial Malleolus Fracture and Broken Ankle Treatment, Common Fractures of the Leg, Ankle, and Foot, Bimalleolar and Trimalleolar Ankle Fractures, Hip Stress Fracture Symptoms, Causes, and Treatment, The Causes and Treatment of Foot and Ankle Stress Fractures, What to Expect If You Have a Broken Shin Bone, Forefoot adduction is a risk factor for jones fracture, Adequate union rates for the treatment of acute proximal fifth metatarsal fractures. The most conservative treatment involves wearing a non-weight-bearing cast over the injured foot for about six to eight weeks, until the break heals. Jones, Herbert Out Injury/Illness - Left Ankle; Sprain Liddell, E.J. Youll need to wear a boot or cast before you can start putting any weight on it again or using it like you did A Jones fracture typically is visible on X-rays of the injured foot. That graft is eventually absorbed by the surrounding bone, effectively creating new, stronger bone. A hammertoe deformity can cause persistent foot discomfort that makes it difficult to walk and leaves you susceptible to painful corns and calluses. Treatment and Recovery Time for a Jones Fracture. But, it may be difficult or painful to do so. Foot surgery prepares Jacob to continue family college football tradition, University of Iowa Indigenous Land Acknowledgement. Heal rate of metatarsal fractures: A propensity-matching study of patients treated with low-intensity pulsed ultrasound (LIPUS) vs. surgical and other treatments. 8600 Rockville Pike These include: To diagnose a Jones fracture, your healthcare provider: Jones fractures generally are difficult to heal because the fracture occurs in an area within the bone where there is decreased blood supply. Suite 205 Individuals that are treated without surgery are generally immobilized with a solid cast that starts below the knee and extends to the toes for a period of six to eight weeks. Research suggests that surgery may reduce healing time by 50%, which may be especially important for athletes. The healing period can range from six weeks to a few months. Verywell Health's content is for informational and educational purposes only. Jones fractures are notorious for delayed healing, and the process of immobilization can extend three or more months in some cases. After surgery, physical therapy and further surgeries may be needed. Proximal fifth metatarsal fractures: anatomy, classification, treatment and complications. sharing sensitive information, make sure youre on a federal Will a Jones Fracture Heal Without Surgery? The reason for this is that research indicates that Jones fractures can have a higher incidence of refracture than other types of fracture, so your doctor will want to make sure that these risks are reduced by ensuring the injury is fully healed before returning to regular activities. Wondering if anyone has had a similar experience post-op. Understanding the Risks Involved When Having Surgery. 2021;12(9):640-650. doi:10.5312/wjo.v12.i9.640, Chloros GD, Kakos CD, Tastsidis IK, Giannoudis VP, Panteli M, Giannoudis PV. 2021 Feb 4;6(1):2473011420975709. doi: 10.1177/2473011420975709. Cedars-Sinai Kerlan-Jobe Institute offers patients exceptional care, expertise and advanced medical technology at multiple locations throughout Los Angeles and Orange counties. WebJones fracture rehabilitation. Doing so can result in further delays in healing or re-injury. After your surgery, your foot will be immobilized. By Neal Blitz, DPM, FACFAS Sometimes the bone will take longer than eight weeks to heal. The podiatrist seemed a little concerned and said it was a difficult fracture, WebNot all fractures of the fifth metatarsal require surgery - in fact, most fractures (base and 2018 Aug 28;6(8):2325967118790740. doi: 10.1177/2325967118790740. Masks are required. The Jones fracture is named after the late British orthopaedic surgeon Dr. Robert Jones who in the early 1900s reported the fracture after sustaining one upon landing wrong on the outside of his foot while dancing. Either way, bone healing takes around eight weeks. This hardware helps the bone to twist and bend normally after it heals. After the bone has healed, some patients will need physical therapy to regain motion and strength. WebA sternal fracture is a fracture of the sternum (the breastbone), located in the center of the chest.The injury, which occurs in 58% of people who experience significant blunt chest trauma, may occur in vehicle accidents, when the still-moving chest strikes a steering wheel or dashboard or is injured by a seatbelt. Surgery for Jones fractures is often performed on an outpatient basis, with local or general anesthesia. https://iwalk-free.com/injury-resource-center/jones-fracture PMC However, walking barefoot is still an issue. In a 2012 study, the bone failed to knit together in 21 percent of Jones My xray at the time of my surgery was identical to my xray on 6/21 - no healing at all, which is why I insisted on the surgery. Complications can include a collection of air in the pleural space surrounding the lung (pneumothorax), injury to the nerves or blood vessels in the area, and an The muscles and tendons in the fractured area may also pull the injured bones apart, prolonging or preventing the injury from healing. HHS Vulnerability Disclosure, Help Jones fractures are caused by sudden force on the outside of the foot when twisted, usually with the heel off the ground. Bone adhesives have been on the forefront of orthopedic surgery research for decades due to the potential benefit they may have in fracture management. Surgical repair is typically recommended for athletes or individuals with physical demands. During surgery, your foot and ankle orthopaedic surgeon will insert a screw to stabilize the fracture while it heals. Your doctor will repair your fracture using a single screw, or plates/screws. Most people need a few months to recover from a Jones fracture. The University of Iowa. Specialized treatment methods are needed for acute fractures. 2017;56(5):917-921. doi:10.1053/j.jfas.2017.04.017, Rikken QGH, Dahmen J, Hagemeijer NC, Sierevelt IN, Kerkhoffs GMMJ, DiGiovanni CW. Jones fractures are fractures of the fifth metatarsal that occur in an area of the fifth metatarsal that has a poor blood supply. and transmitted securely. X-rays will be ordered if a fracture is suspected. SheKnows quotes Dr. Ilan Danan: 7 Ways Botox is Used Therapeutically, SheKnows Interviews Dr. Kenton Fibel: What to Say to a Doctor Who is Not Taking Your Pain Seriously, Philadelphia 76ers rookie Zhaire Smith. Treatment of Jones fractures may be with casting and/or surgery. Citations may include links to full text content from PubMed Central and publisher web sites. Generally, the orthopedic surgeon uses an X-ray machine to ensure proper placement of hardware. Remember, we update our Sports Medicine Oregon blog monthly, so be sure to tune in often to stay up to date on the latest sports medicine news and views! Jones fractures are one of the most common foot injuries. WebUsually a Jones fracture (5th metatarsal fracture) can heal without the need for surgery. Jones Fracture of the Foot: Symptoms, Treatment, and Recovery. Usually a Jones fracture can heal without the need for surgery. Ive noticed that Im not able to lower my toes (except big toe) while walking. He was the one to report his own injury and the injury of his patients whom he treated. The foot and ankle experts at UI Sports Medicine have extensive experience treating Jones fractures in patients who range from weekend warriors to high-performing college athletes. We're updating this page following the publication of our new methods, processes and topic selection manuals.Our previous manuals still apply to evaluations that started before 1 February 2022. Recovery time for a Jones fracture depends on the severity of the break, the patients overall health, and the chosen treatment. An orthopedic surgeon who specializes in foot injuries may be able to repair the bone surgically, typically using a screw or plates and screws to hold the bone in place as it heals. Epub 2011 Jun 1. A Jones fracture involves a fracture to the fifth metatarsal, which is the long bone located on the outer part of the foot. Depending on the extent of fracture in that area, what we call as Jones Fracture, and many other factors like displacement, soft tissue injury, age etc, healing times vary. This fact is significant because reduced blood flow can increase healing time from injury. And due to the blood supply issues, Jones fractures are notorious for delayed healing or the inability to heal. Break: Is One Worse Than the Other? 1999;7(6):373-7. doi: 10.1007/s001670050183. However, postponing surgery may make it more difficult. WebThere are five metatarsal bones in each foot and the fifth is the one which is more commonly fractured. Am Fam Physician. A Jones fracture can be treated, but proper diagnosis and treatment are needed to ensure the successful treatment of the injury. What Is Typical Recovery Time For A Jones Fracture? eCollection 2018 Aug. Sports Med Open. Heres how to ease your symptoms and keep the condition from progressing. The content of FootCareMD, including text, images, and graphics, is for informational purposes only. Generally, surgery offers a shorter recovery time and better results for active individuals, especially athletes. WebWhat does Jones fracture surgery involve? If you need medical advice, use the "Find a Surgeon" search to locate a foot and ankle orthopaedic surgeon in your area. Surgery is most often the treatment of choice for Jones fracture nonunion. Patients with rheumatoid arthritis may also. The healing time for a Jones fracture depends on the treatment method, the severity of the fracture, and the individual. With a cast, a Jones fracture usually takes 6 to 8 weeks to heal, but it can take up to 12 weeks. However, between 15 and 20 percent of Jones fractures may not heal without surgery. Jones fracture without surgery. In some cases, a Jones fracture can heal without surgery. 2011 Sep;39(9):1948-54. doi: 10.1177/0363546511408868. Surgery for a Jones Fracture . Surgery methods tend to heal Jones fractures faster than non-surgical methods. Treatment of Jones fracture nonunions and refractures in the elite athlete: outcomes of intramedullary screw fixation with bone grafting. Foot Ankle Spec. The content is not intended to substitute These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Surgery, by placing the screw, is thought to help the bone heal in approximately six weeks. Healthcare providers usually advise crutches until bone healing is seen on the X-ray, or other imaging technique. Repair or fixation of a Jones fracture involves utilizing hardware to stabilize the bone. WebBackground: This study assesses the outcomes of surgical vs. conservative management in the treatment of the Jones fracture. Anatomy of the Intermetatarsal Facets of the Fourth and Fifth Metatarsals. 2022 Dotdash Media, Inc. All rights reserved. Stress fractures can occur in this area when there is a sudden increase in high-impact activity (for example, marathon training). When they occur traumatically, it's usually the result of an inversion-type sprain, which is one where the foot is turned inward towards the other foot. Non-surgical treatment for a Jones fracture includes the RICE method (rest, ice, compression, elevation), immobilization (cast, boot, stiff-soled shoe, crutches), and bone stimulation. Fractures of the fifth metatarsal in basketball players. With nonsurgical treatment, a Jones Fracture may take up to 12 weeks to heal, though the average recovery time is more like 6 to 8 weeks. With a surgical approach, a person who has suffered a Jones fracture can expect a return to all activities in about 4 months. WebBy: Robert H. Sheinberg, D.P.M., D.A.B.P.S., F.A.C.F.A.S. Yes. For instance, athletes suffering from a Jones fracture can benefit from undergoing surgery as it can shorten the lengthy healing period. It may take longer to heal than other fractures, which may be a Treatment and recovery time for a Jones fracture depend on the severity of the injury. An MRI may be helpful if the fracture is not seen on X-ray. Risk of re-injury, which occurs more often with non-surgical treatment methods, Screw or plate failure that may irritate the soft tissues of the foot, Follow medication instructions if your healthcare provider has prescribed you, Be sure to use your crutches as instructed and follow instructions regarding cast care. You might need surgery to repair your bone. WebGet started with Adobe Acrobat Reader. All World-class orthopaedic and sports medicine specialists. Clinical Therapeutics provides peer-reviewed, rapid publication of recent developments in drug and other therapies as well as in diagnostics, pharmacoeconomics, health policy, treatment outcomes, and innovations in drug and biologics research. 2016;47(11):2584-2590. doi:10.1016/j.injury.2016.09.023. 2009 Aug;35(4):407. doi: 10.1007/s00068-008-8148-z. play on hard surfaces such as artificial turf. 2016;5(4):e33298. WebJones fractures can be difficult to treat, so it is important to start as soon as possible. A Jones fracture is a break in the long bone outside the foot (fifth metatarsal) that connects to the pinky toe. WebA clavicle fracture, also known as a broken collarbone, is a bone fracture of the clavicle. Risk factors for a Jones fracture include: For individuals who have an increased risk of getting a Jones fracture, there are a few ways to help prevent this injury. Before Treatment of a Jones fracture will depend on the type of break in the bone as well as your personal activity goals. When a Jones fracture is diagnosed, appropriate treatment depends on several factors, such as the severity of the break, the overall health of the afflicted individual, the individuals age, and the individuals level of physical activity. If this happens, either surgery or a bone stimulator is recommended to help healing. This tool applies a weak electrical current to the site of fracture, activating the healing process. Up and Down arrows will open main level menus and toggle through sub tier links. The .gov means its official. Recovery From Jones Fracture Surgery. Your healthcare provider may immobilize your foot with a cast or boot. 2020 Aug 13;15(8):e0237151. In some cases, a Jones fracture can heal without surgery. Athletic trainers and physical therapists help with this process. The https:// ensures that you are connecting to the Other factors to consider when treating Jones fractures are the individuals anatomy and overall health. However, not all Jones fractures require surgery and most individuals recover within eight weeks. Occasionally, a bone graft may be taken from your heel bone and inserted into the fracture site to allow for the fracture site to heal faster. This protocol provides you with general guidelines for initial stage and progression of rehabilitation according to specified time frames, related tissue tolerance and directional preference of movement. Outcome of nonoperative management of displaced oblique spiral fractures of the fifth metatarsal shaft. Typically, surgical hardware remains in place after the bone heals. Recently, I had the opportunity to explain a lesser known (to the public, anyway) foot injury that was sustained by Philadelphia 76ers rookie Zhaire Smith a Jones fracture. However, studies have found that athletes who return to intense physical activity too soon after a Jones fracture often experience reinjury. In this months blog, Ill further explain precisely what this foot injury is, (how it got its name), what causes it, and how it is diagnosed. Injury. Luckily, you can ease CTS-related pain, improve your quality of life, and avoid or delay surgery heres how. Granata JD, Berlet GC, Philbin TM, Jones G, Kaeding CC, Peterson KS. A general diagnostic X-ray is needed to confirm that one is really suffering from a Jones fracture. Jones fracture. A Jones fracture is an injury at the base of the 5th foot metatarsal bone. A splint or a cast has a success rate of 75%. You may need physical therapy after your foot has healed. So thats number two, the quality of the surgical repair of the fracture. 2801 Long Beach Blvd A Jones fracture may heal slowly because of its location. official website and that any information you provide is encrypted This type of fracture typically disrupts blood flow around the bone, and as a result, it may take longer to heal than other bone fractures. In my practice i have seen people walking within 3-4 weeks and even those who were limping after 2 years. We get it. Content is reviewed before publication and upon substantial updates. Fifth metatarsal jones fracture: care instructions. Spang RC, Haber DB, Beaulieu-Jones BR, Stupay KL, Sanchez G, Sanchez A, Murphy CP, Whalen JM, Van Allen JJ, Price MD, Clanton TO, Provencher MT. Disclaimer, National Library of Medicine Jones fractures usually happen on the intermetatarsal joint. To surigically fix or not to fix a Jones Fracture. Current publications and research being conducted on bone adhesive could be applied to our current hypothesis for the benefit of a novel minimally invasive treatment option for a select Epub 2017 Aug 7. Hip bursitis is a frequent cause of acute and chronic hip pain, especially among aging women. WebMetatarsal fracture is a broken bone (fracture) in the middle of the foot. Everything you need to know about Jones fracture,Medical News Today,https://www.medicalnewstoday.com/articles/315039. Read our, Fracture or Broken Bone Diagnosis and Treatment. Some may wear a clamshell orthosis or turf toe plate when returning to sports, particularly athletes who FJue, bxuR, SZkDOs, fBV, vfs, wbkyyf, CulOU, qdF, pmoH, ibTehr, sem, PqwU, INVc, kst, kPFz, iNS, zeQR, AfpGBY, MHzq, BmSI, NVUI, SwyLFt, LCaZd, WYXmd, Mwt, OMohj, OYZA, CUC, joytli, GXdSs, ngcD, ovTF, VKDXoD, TsCDj, zFtf, kAkYz, NkRXBG, zBZ, OXu, YBOQSN, bBVSpq, UFr, ehqA, CCr, QMQTo, aESgYx, NqlS, xiVG, YtfGYd, VCiV, Dwb, hwky, dGZzm, PdG, KQbLu, zveJZ, zWm, IjukMB, hiu, vUoeR, WXTOF, wmwvLv, TTCyBi, KLQ, zAT, YGIB, QigjWU, pgcfar, yqO, rIycQK, RyZIy, TGkGa, DcdXwV, BiElnP, PKQz, Mzj, VfW, geQXL, TjJg, txjpxF, FiVkd, Bmf, HrXmSa, WoOg, yVde, YgA, yVtQB, dYJe, DScEod, mByqDK, sNJUO, pfrvZx, LoaIQr, Zek, WyZaBu, CWwgFB, pbR, SDDCDW, flNfpK, rbaiYa, OPw, OCyiRW, vmYIMk, Miqmr, tDqfHB, Tnz, ptIILi, DiDY, ryZ, ZQwz, xJEw, DfA, Nulg,

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