Download Orthopaedic Glossary

Orthopaedic Glossary Specialized for Sports Rotation
ABSCESS- A fluid-filled structure that is infected and contains pus. It can be within a
bone or entirely within the soft tissue.
ACHILLES TENDON (TRICEPS SURAE)- This tendon attaches the gastrocnemius and
soleus muscles (located in the back of the calf) to the calcaneus (heel bone). The
Achilles tendon works with these calf muscles to plantarflex the foot. The posterior calf
muscles pull the calcaneus (heel bone) to bend your foot downward when you walk or
when you raise up on the balls of your feet. The Achilles tendon is also known as the
tendo calcaneus. The Thompson test reliably predicts the presence or absence of a
complete Achilles tendon tear.
ANKLE INSTABILITY – This condition refers to abnormal motion in the ankle joint.
Normally, two ligaments keep the ankle joint from rolling inward (inverting) or outward
(everting). These ligaments are the anterior talofibular ligament and the calcaneofibular
ligament. If either of these ligaments ruptures, the ankle becomes unstable.
There is a stress test to help diagnose instability in the ankle, which is carried out
after the acute symptoms from an ankle injury subside and the overall symptoms
persist, allowing the ankle to give way while the patient is walking. See also:
Ligament.
ANKLE JOINT – The joint between the talus and the tibia, or tibiotalar joint. Because
of the structure of the tibia, the ankle joint only moves in dorsiflexion and plantarflexion
(upward and downward, or towards the head and towards the floor). The more complex
motion of the ankle—the ability to roll it inward, outward, and around in circles- is
actually allowed by other joints in the foot, though it may feel to you like only one joint
is working.
For a lateral view of the ankle joint, see: http://en.wikipedia.org/wiki/Image:Ankle.PNG
For more details on these joints, see Foot.
ARTERY- An artery is a blood vessel that carries blood away from the heart to the body
(as distinguished from a vein, which carries blood from the body back to the heart).
Blood in an artery carries oxygen from the lungs to the other parts of the body.
ARTHRITIS- Arthritis refers to inflammation of a joint. There are many types of
arthritis, including:
Osteoarthritis, or the wear-and-tear type of arthritis, which involves the breakdown of
the cartilage in the joints over time. Any joint that suffers from overuse or traumatic
injury may be vulnerable to osteoarthritis later in life.
Rheumatoid arthritis, is an autoimmune disorder (in which a person’s own immune
system attacks healthy cells and tissues). With this condition, the patient’s immune
cells attack the membrane called the synovium, which lines the joints, causing
inflammation, pain, redness, and warmth in the joints. The cells of the synovium
grow and divide abnormally and start to destroy the cartilage and bone in the joint. If
untreated, deformity in the joint will eventually occur. The surrounding muscles,
ligaments and tendons can also become weak and are not able to support the joint.
AVASCULAR NECROSIS- This refers to the death of a body structure after losing its
blood supply. With avascular necrosis of the bone, the bone becomes brittle, and can
collapse, causing deformity. Degenerative arthritis can occur and become quite severe
and progressive. For example, reduction of blood flow to the hip joint can lead to
degeneration in the joint, loss of bone mass, and some degree of collapse in the joint. In
children, avascular necrosis of the hip occurs in a condition called Perthes disease.
BONE- Bones help to provide a rigid, supportive framework for the body and to protect
the vital organs. Many bones also function as levers that the muscles act upon to help the
body move. Bones are strong, but also light and springy, due to their unique structure.
Bones consist of living cells, fibers of a protein called collagen, as well as various
mineral salts of calcium; these inorganic minerals are responsible for the hardness of
bone. All bones are surrounded by a thin but tough membrane called the periosteum,
which contains blood vessels. Immediately beneath this outer “skin,” there are two types
of bone: compact bone and spongy bone.
Compact bone makes up the hard, dense outer portion of the bone, which takes the
most stress. The live bone cells, called osteocytes, are trapped in tiny chambers called
lacunae within the hard, inorganic material. The osteocytes receive nutrients and
other chemicals needed to perform their functions, such as oxygen, by joining with
other cells through tiny tubular passageways called canaliculi. The osteocytes use the
nutrients as building blocks for repair of the bones, which is one of their main
functions. If the osteocytes die, the bone becomes weak. This can lead to fracture or
collapse.
Spongy bone makes up the inner layer of bone; it contains many small empty spaces
to help reduce weight. There is more spongy bone near joints--for example, at the
ends of the long bones of the arms and legs – to help the bone withstand impact.
Long bones also have a central cavity called a medullary canal that contains bone marrow,
a substance that stores fat and makes blood cells.
BUNION- A prominent swelling over the head of the first metatarsal (which is located at
the MP joint between the metatarsal and phalanx). This can occur due to muscle
imbalance, for example, when women wear shoes that are two narrow and the toe is
pushed over, deforming the foot.
BUNIONETTE- A prominent swelling similar to a bunion, except that it occurs at the
MP joint of the fifth toe rather than that of the great toe.
CALLUS- A thickening and hardening of the skin over a bony prominence. This can
occur anywhere there is repetitive rubbing, and can be painful. See also: Corn.
CAPILLARY – The small terminal end of an artery prior to its becoming a vein.
CARTILAGE – Typically found between bones in adults, cartilage permits smooth
movement of joints. It’s a rubbery, fibrous, dense tissue that acts as a cushioning surface
between the bones. Cartilage is a major constituent of the embryonic and young child’s
skeleton; it is replaced by bone cells as children grow. When a bone is fractured, it first
heals with cartilaginous material, which is later replaced by bone.
Cartilage is made up of specialized cells that are held in place in a structure called a
matrix. The matrix physically supports the cells and provides them with nutrients; unlike
in bone, there are no canals for the cells to receive nutrients
There are two main types of cartilage: hyaline, which has special characteristics that
allow it to bear weight around bones, and fibrocartilage, which doesn’t bear weight.
Hyaline cartilage doesn’t reproduce itself to repair damage; only fibrocartilage can do
this. This becomes an issue in injuries. When hyaline cartilage is damaged, it is almost
invariably recreated as the rough fibrocartilage, which results in decreased functioning of
the joint.
CELLULITIS- A redness (erythema) of the skin due to bacterial infection. The redness
spreads until treated with antibiotic.
CHARCOT or NEUROPATHIC JOINT- A joint that deteriorates, collapses, or becomes
arthritic due to a loss of its nerve supply. This occurs in patients with diabetes or
peripheral neuropathy.
CLUB FOOT- A deformity of the foot, in which the child cannot stand on the sole of the
foot since it is turned inward. This deformity is usually fixed and present at birth.
CORN- Thickened and hardened area of abnormal skin over a bony prominence of the
foot. In the hands, they are called calluses.
CUNEIFORM BONES- There are three cuneiform bones in the foot. The cuneiform
bones are located between the first, second, and third metatarsal bones and the navicular
bone.
The three cuneiform bones, the navicular bone, and the cuboid bone are also known as
the tarsal bones. Where the tarsal bones meet the metatarsal bones, the joints are called
Lisfranc’s joints. When fractures occur here, they are called Lisfranc’s fractures. A
synonym for these joints are the tarsometatarsal joints.
To view the locations of cuneiform bones, see this diagram:
http://www.icbmedical.com/__data/page/104/Foot-Bone-Structure3.gif
See also: Foot.
CYST- This refers to a lesion within a bone or soft tissue. It consists of a firm
surrounding surface such as on a balloon and is filled with water, prurulent material (pus),
or other substances.
DISLOCATION- This occurs when the bones which meet at a joint are displaced from
their normal position. The dislocation is described according to the direction in which it
occurs. For example, a shoulder dislocation, in which the ball of the shoulder joint is
separated from the socket of the scapula, can be an anterior dislocation, a posterior
dislocation or an inferior dislocation. A subluxation is an incomplete or partial
dislocation of the bones.
ECCHYMOSIS- An accumulation of blood under the skin caused by the escape of blood
into the tissues from ruptured blood vessels. This occurs when there is a hemorrhage in
soft tissue and typically appears black and blue.
EPIPHYSEAL PLATE- A structure from which growth occurs at the end of a bone in
young people. When bones grow longer, the growth occurs mainly at these plates. When
they solidify at the end of adolescence, adult height has been reached.
EPIPHYSIS- The epiphysis growing end of a long bone in a young person; it is the last
part of the bone to ossify, or harden into mature bone.
FASCIA- A layer of fibrous connective tissue that covers and supports muscles and other
soft tissue structures.
FOOT- The foot has three main portions: the forefoot, the mid-foot, and the hind foot.
These work together to allow the foot to be as flexible or as rigid as needed. The foot is
an extremely complex structure, with all of the joints working together so that the foot
can move in numerous directions.
Forefoot – This portion of the foot includes the metatarsals and the phalanges (toe
bones). It extends from Lisfranc’s joints (the joints between the tarsal bones and the
metatarsal bones) distally to the ends of the phalanges.
Mid-foot- This portion of the foot includes the tarsal bones (the 3 cuneiform bones,
the cuboid, and the navicular). It extends from the forefoot at the Lisfranc’s joints to
meet the hindfoot at Chopart’s joint.
The midfoot permits certain types of motion that are not permitted anywhere else in
the foot , specifically abduction and adduction with rotation. In addition, this portion
of the foot functions in absorbing various stresses. For example, if you fall off of a
horse flat on your feet, all of the stress is at the Lisfranc’s joints.
Hind foot- This portion of the foot is made up of the talus and the calcaneus.
Where the talus meets the calcaneus, it is known as the subtalar joint. This joint
allows inversion and eversion of the foot.
The talus meets the tibia at the main ankle joint, or tibiotalar joint. This joint allows
dorsiflexion and plantarflexion of the foot.
FRACTURE- A fracture of any structure indicates a break in the continuity of the
structure. As related to bone, there are different types of fractures; some are listed below:
Simple fracture- a fracture that occurs along one line, splitting the bone into two
pieces.
Comminuted fracture- a fracture in which the bone is broken into more than two parts.
Closed fracture- a fracture in which the bone does not pierce the skin.
Open fracture- a fracture which includes lacerated soft tissue or an open wound.
Osteochondral fracture - a chip fracture, such as from the joint surface of the talus
from its medial corner or lateral corner. This fracture is commonly associated with
ankle sprains and requires more prolonged treatment including possible surgery. A
surgical technique called arthroscopic debridement can be used to get the fracture to
heal and relieve symptoms.
Stress fracture- A stress injury or fracture, sometimes called a March fracture, is a
fracture of a bone caused by repetitive stress over a period of time, such as a forced
long march for army recruits.
FRACTURES, UNION OFDelayed union- the delay in the healing of a fracture for an abnormally long period,
usually more than 6 months. A bone that is delayed in its union will sometimes, but
not always, become a nonunion.
Nonunion- the failure of a fractured bone to heal normally. This term is used when
the bone is not healed after one year.
FUSION – Fusion refers to the joining together of two bones such that motion can no
longer occur between them; the two bones are essentially locked up into one.
Orthopaedic surgeons can fuse bones purposely in order to stop movement and relieve
pain in an arthritic joint by putting in bone grafts or other material.
HALLUX- The great toe. In some children, the bones of the foot develop abnormally and
an extra bone called an accessory navicular is present toward the inside of the foot, in
front of the ankle. This condition is called Kidner’s Pre-Hallux, and is associated with
flat-footedness.
HALLUX RIGIDUS or HALLUX LIMITUS- Hallux rigidus or Hallux limitus refers to
arthritic stiffening of the metatarsophalangeal joint of the great toe. (The
metatarsophalangeal joint, or MP joint, is the joint between the metatarsal bone and the
phalanges.)
HAMMER TOES- This is a deformity of the lesser toes, characterized by calluses on the
top of the phalanges and on the bottom of the metatarsals. They are of variable severity,
and they may or may not require surgical correction if shoe adjustments fail to relieve
pain.
HEMATOMA- A collection of blood anywhere in the body caused by the leakage of
blood after the rupture of a blood vessel.
JOINT- This is a connection between two bones. There are 3 types of joints:
Diarthrodial (or synovial) joints - freely movable joints. Most joints in the body are
diarthrodial joints; the knee is one example. At the joint, the opposing bony surfaces
are covered with a layer of hyaline cartilage. There is a synovial lining of cells which
secrete a fluid (called synovial fluid) into the joint, improving its sliding
characteristics.
Amphiarthrodial joints- slightly movable joints. The bones in this kind of joint are
united by fibrocartilage rather than hyaline cartilage [See Cartilage, above]. The
joints allow a small amount of motion. An example is the sacroiliac joint -- the joint
between the sacrum, at the base of the spine, and the ilium of the pelvis.
Synarthrodial joints - immovable joints. In synarthrodial joints, the two bones are
essentially fused together. The ends of the bones are no longer cartilage but are made
up of a bony structure. This totally immobilizes the bone and greatly increases
stability. The sutures of the skull are an example. In a growing infant, the places
where the bone plates in the skull come together have soft parts; at this point, the
bones are movable. These bone plates later fuse together during growth and become
synarthrodial joints.
LACERATION- a tear of the skin or other soft tissues, resulting in a space between the
cut surfaces.
LIGAMENT- a band of flexible, fibrous soft tissue that connects two bones; it is attached
at the end of a bone near a joint. The main functions of a ligament are threefold: to attach
bones to one another, to provide stability of a joint, and to prevent or limit some joint
motion. When ligaments are torn, it results in instability of the injured joint. The
following are some examples of ligaments:
Anteriofibular ligament (or ATF ligament) - a ligament on the lateral side of the ankle.
When this ligament is completely torn, it results in instability in the ankle; the talus
can be pulled anteriorly out of its normal position.
Calcaneofibular ligament (or CF ligament) - a ligament on the lateral side of the
ankle; it connects the fibula with the calcaneus. The CF ligament keeps the ankle
from rolling over on its side. If this ligament is completely torn, the calcaneus can
roll inwards excessively and the talus can be displaced out of the joint. See also:
Ankle Instability.
MALLEOLUS- A projection at the end of each lower leg bone at the ankle joint. These
expanded ends of the tibia and fibula allow for broad attachments of ligaments and
increased strength of the ankle joint.
Medial Malleolus- The medial malleolus is the expanded distal end of the tibia at the
ankle. It is located on the medial side of the ankle.
Lateral Malleolus- The lateral malleolus is the expanded distal end of the fibula at the
ankle. It is located on the lateral side of the ankle.
MIDTARSAL JOINT- The joint between the calcaneus and the cuboid bone on the
lateral side (calcaneal cuboid joint) and the joint between the talus and the navicular bone
on the medial side (talonavicular joint). It connects the bones of the forefoot (the tarsal
bones) with the bones of the hind foot. This joint works with the other joints in the foot
and ankle to allow rotational movements. It is also called Chopart’s joint and transverse
tarsal joint.
To view the locations of the bones that meet at this joint, see this diagram:
http://www.icbmedical.com/__data/page/104/Foot-Bone-Structure3.gif See also: Foot.
MUSCLE (SKELETAL) - Muscle is contractile tissue, made up of cells that have the
unique ability to shorten the surrounding structures as an electronic impulse passes
through it. Skeletal muscles are generally attached to the skeleton by means of tendons.
When electrical impulses are sent from the nervous system, the muscle fibers are
stimulated to contract. Shortening of the muscle fibers results in motion of the attached
tendon; this then results in movement in the joint.
Depending on the need for motion or the need for strength and stability, the range of
motion of the tendon (and therefore the range of motion of the joint), varies greatly from
one joint to another. For example, the finger joints have a relatively large range of
motion.
Skeletal muscles only pull in one direction. For this reason, they almost always come in
pairs. When one muscle in a pair contracts, for example, to bend a joint, its partner
muscle then contracts and pulls in the opposite direction to straighten out the joint.
NERVE- A nerve is a highly specialized structure which transmits electric impulses from
the nerve body along an axon to a muscle, which results in contraction of the muscle.
Nerves also send impulses to sensory neurons, which transmit sensations such as touch,
vibration, warmth, etc. Some nerves have the ability to be regenerated when they are
injured; others do not.
OSTEOPENIA- Osteopenia refers to an early stage of osteoporosis which can occur in
young women. In osteopenia, there is a reduction in bone density or bone mass below
normal levels. It is diagnosed by evaluating the density of the spine and pelvis. See also:
Osteoperosis.
OSTEOPOROSIS- Osteoporosis is a loss of bone strength and density affecting primarily
older women. The word osteoporosis means “too little bone.” In this condition, the bone
is normally calcified (or hardened by the deposit of calcium salts), but there is not a
sufficient amount of it to create normal strength for the bone.
PRESSURE ULCERS- Pressure ulcers are caused by chronic, unremitting local pressure
on an area when an individual is confined to bed and is not frequently moved to keep
pressure off of the area. Pressure ulcers can develop over areas such as the heel, greater
trochanter of the hip and sacral region.
PULSE- A pulse is a throbbing sound in an artery produced by the contraction of the
heart, which is both palpable and audible. The intensity of the pulsation can be measured
with a blood pressure cuff or similar device.
SPRAIN- A partial or complete tear of a ligament. Degrees of severity of sprain are as
follows:
1st degree sprain- a stretch or partial tear of the ligament with no instability.
2nd degree sprain- this is a more extensive tear of the ligament; however, enough
tissue is intact to prevent instability.
3rd degree sprain- a severe injury resulting in complete separation of the ligament and
therefore, instability of the joint.
STRAIN- a strain is a partial or complete tear of a muscle.
TARSAL COALITION - an abnormal fusion of one or more of the tarsal bones.
Coalitions can occur between the talus and the calcaneus, the calcaneus and cuboid, the
talus and navicular, and the calcaneus and navicular. In the latter type of coalition, the
navicular fuses with the anterior process of the os calcis (the portion of the calcaneus
bone that projects distally toward the navicular bone).
TENDON- a strong, fibrous soft tissue structure which connects muscle to bone. Each
tendon connects at a bony insertion (or place of attachment). Contraction of the muscle is
transmitted through the tendon to the bone, resulting in active motion in the joint. The
rupture of a tendon can result in the inability to flex or extend at a joint. See also Muscle.