The bones that make up our legs and feet
Femur – The femur is the longest and strongest bone in your body. It is the thigh bone and is located between the hip and knee.
Patella – The patella is your kneecap – triangular bone between the femur and tibia
Tibia – The larger, bone of the lower leg that extends from the knee to the ankle.
Fibula – The smaller but most prominent bone on the outer side of the ankle that also extends to the knee. The tibia is not a weight bearing bone. Its job is to articulate with the ankle.
Talus – The ankle bone. Turtle shaped bone that sits between three joints. The three joints are: the ankle, which allows the up and down motion of the foot with the leg; the subtalar joint, which allows inversion and eversion of the foot with the leg; and the talonavicular joint, which has a complicated biomechanical function that controls flexibility of the foot and the arch of the foot. The talus has no muscular attachments and is mostly covered with cartilage. Being covered with cartilage and having a precarious blood supply, injuries to the talus are difficult to heal.
Calcaneus – is your heal bone
Cuboid – The midfoot bone on the outside of the foot. This bone is between the calcaneus and metatarsals.
Navicular – A boat-shaped bone in the midfoot. It is part of two joints: the talonavicular joint, which has a complicated biomechanical function that controls flexibility of the foot and controls the arch of the foot; and the naviculocuneiform joint.
Cuneiform – Three cuneiform bones are present in the foot: the medial cuneiform, the intermediate cuneiform and the lateral cuneiform.
Metatarsals – your toes
Malleolus – Bony prominence at the end of the fibula and tibia. The bumps on each side of your ankle. Fractures of the malleolus at the bottom of the tibia are the most common ankle fractures.
Soft Tissues in our legs and feet
Cartilage – A smooth, surface that covers the ends of bones that articulate with each other to form a joint. Cartilage cushions the bones and absorbs shock.
Tendon– fibrous connective tissue that attaches muscles to bone.
Skeletal muscle– fibers composed of striations that move bones of the skeleton and work mainly in a voluntary manner.
Ligament – tissue that connects two bones to stabilize a joint
Peroneal tendon – The peroneal tendons are behind the outside bone of the ankle (the fibula). Moves the foot outward in a direction called eversion. They also balance the ankle and the back of the foot and prevent the foot from turning inwards repetitively. The peroneal tendons are susceptible to injury as the ankle turns, rolls or becomes sprained because they are not as strong as the muscles and tendons on the inside of the ankle.
Plantar fascia – Plantar fascia is a thin layer of tough tissue which runs along the bottom of the foot supporting the arch of the foot.
Posterior tibial tendon – The posterior tibial tendon and other supportive ligaments help maintain the arch of the foot. This tendon goes behind the ankle and around a bone inside the ankle called the medial malleolus.
Ligaments of the knee– There are two cruciate ligaments located in the center of the knee joint. The anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL) they are the major stabilizing ligaments of the knee. Both of these ligaments stabilize the knee in a rotational fashion. Thus, if one of these ligaments is significantly damaged, the knee will be unstable causing the knee to buckle and give way.
Hamstrings – Three muscles in the posterior region of the buttock and thigh that provide an extension force at the hip and a flexion force at the knee.
Achilles tendon – The Achilles tendon is a tough band of fibrous tissue that connects the calf muscles to the heel bone (calcaneus). The Achilles tendon is the largest and strongest tendon in the body. When the calf muscles flex, the Achilles tendon pulls on the heel. This movement allows us to stand on our toes when walking, running, or jumping. Despite its strength, the Achilles tendon is also vulnerable to injury, due to its limited blood supply and the high tensions placed on it.
Lateral meniscus – The lateral C-shaped fibrocartilaginous structure of the knee
Joints
Ankle joint – The joint between the foot and the lower leg. The anatomy of the ankle is made up of three bones the tibia, fibula and talus. The tibia is the long bone of the lower leg and the weight bearing bone. The fibula is the smaller bone that runs down the outside of the leg and the talus is underneath. This is the true ankle joint and is responsible for the up and down motion. On the underside of the talus is the second part of the ankle which allows the side to side motion of the foot. It is called the subtalar joint and is where the talus and calcaneus (heel) meet.
Knee –The knee is a hinged joint essentially made up of four bones. The femur attaches by ligaments and a capsule to your tibia. Just below and next to the tibia is the fibula, which runs parallel to the tibia. The patella, or what we call the knee cap, rides on the knee joint as the knee bends.
Closed fracture (simple fracture) – the bone is broken with no open wound.
Open fracture (compound fracture)- the end of a bone pierces the skin, creating an open wound.
Green Stick fracture – there is an incomplete break of a soft bone.
Comminuted fracture – bone is broken into pieces.
Impacted Fracture – The broken ends of a bone are forced into one another, many bone fragments may be created by such fracture.
Incomplete fracture – the line of the fracture does not include the whole bone
Fracture Treatments
Closed fracture treatment (closed reduction) – Fracture is manipulated or realigned without surgery.
Open fracture treatment (open reduction) – fracture site is surgically opened or exposed to realign the bone.
External fixation device – Hardware is inserted through bone and skin and held rigid with cross braces outside of the body. (Ilizarov external fixator) Often called a hallo
Internal fixation device – Pins, screws and /or plates or titanium rod are inserted through or within the fracture area to stabilize and immobilize the injury.
Long-leg cast – a cast applied to immobilize the leg from the toes to the upper thigh. It is used in treating fractures of the tibia, knee, femur and dislocations of the knee; for maintaining postoperative positioning and immobilization of the knee, distal leg, and ankle. The cast is constructed from plaster or a light weight fiberglass material.
Short-leg cast – a cast used for immobilizing fractures in the lower extremities from the toes to the knee. The short-leg cast is also used for treating severe sprains and torn soft tissue of the ankle, for maintaining postoperative positioning and immobilization of the foot and the ankle, and for correcting or maintaining the correction of deformities of the foot or the ankle. The cast is constructed from plaster or light weight fiberglass material.
Walking cast a lower extremity cast with an attached heel or other support so that the patient is able to ambulate while the cast is in place. The cast is constructed from plaster or light weight fiberglass material.
Splint – Device used to immobilize part of the body. Most commonly used post-surgery for a week to ten days. The splint allows for swelling without causing problems. Most often constructed from thick padding covered by a plaster back slab finished off with ace bandage wrapping.
Orthopedic boot – they come in many forms. They are called cam walkers, orthopedic boots, walking boots and walking casts. They are devices that are used in place of a plaster cast to immobilize and protect many types of foot and ankle injuries. Most often used for injuries that don’t require non weight bearing but can be used for non-weight bearing issues as well. They are easily removable for showering.
NWB – No weight can be placed on affected leg or foot. Fully dependent on crutches for walking.
PWB – Follow doctor recommended weight bearing. Leg takes some of the weight and the crutches take the rest.
Other Common Injuries
Sprain – Trauma to a joint that causes injury to the surrounding ligament.
Strain – Trauma to a muscle from overuse or excessive forcible stretch.
Tendonitis – Inflammation of a tendon, usually caused by injury or overuse.
Contracture – Fibrous connective tissue in the skin, fascia, muscle, or joint capsule that prevents normal mobility of the related tissue or joint.
Osteochondral fractures – Injuries that disrupt articular cartilage and the underlying subchondral bone
Osteochondritis dissecans (OCD) –A localized abnormality of a focal portion of the subchondral bone, which can result in loss of support for the overlying articular cartilage
OATS (osteochondral autograft transfer system) – Cartilage transfer procedures involve moving healthy cartilage from an area of the knee that is non- weight bearing to a damaged cartilage area of the knee or ankle. Plugs of healthy cartilage and bone are taken from a healthy cartilage area and moved to replace the damaged cartilage area of the knee or ankle.
Plantar fasciitis – An inflammation and small tearing of the plantar fascia. Symptoms are usually pain at the bottom of the heel with the first step in the morning. Nonoperative treatment is usually successful.
Anterior Cruiate Ligament Injury ACL – This ligament plays an important roll in allowing your knee to pivot. Injury can occur from twisting stress. Most serous is tearing the ACL.
Menisus or Cartilage Tears – The menisus is the spacer between the two bones of the knee. The menisus can tear with long term wear and tear.
Achilles rupture – A rupture of the Achilles tendon is a complete break in the tendon. Surgery is required to repair the rupture.
Dislocation – Total displacement of bone from its joint.
Complications
Avascular necrosis – A condition in which cells die as a result of inadequate blood supply, bone death.
Compartment syndrome – reduction of blood supply of the nerves and muscles within a fascial compartment caused by elevated pressure (swelling) within the compartment; frequently seen in association with tibial fractures. Can be caused by pressure from a cast that is too tight. Can cause death to tissues.
Delayed union – A delay in normal fracture healing; not necessarily a pathologic process
Malunion – Healing of a fracture in an unacceptable position
Nonunion- Failure of healing of a fracture or osteotomy.
Hematoma – A collection of blood resulting from injury
Disease
Degenerative joint disease – Deterioration of the articular cartilage that lines a joint, which results in narrowing of the joint space and pain; osteoarthritis
Osteoarthritis (OA) – A deterioration of the weightbearing surface; distinguished by destruction of the cartilage and narrowing at the joint space.
Rheumatoid arthritis – A chronic inflammatory disease that is probably triggered by an antigen-mediated inflammatory reaction against the synovium in the joint
Other Terms
Allograft – Biologic tissue from a cadaver that is used to surgically replace damaged tissue. Allogenous grafts – tissue transplanted from one persons to another
Autograft – Biologic tissue from the patient’s own body that is used to surgically replace damaged tissue.
Autogenous – from patient’s body
Grafts – procedure that moves healthy tissue from one site to another to replace diseased or defective tissue. In repairing a fracture a small graft is often taken from the iliac crest of the pelvis and inserted in the fracture site.
Arthrodesis – The surgical fusion of a joint. The procedure removes any remaining articular cartilage and positions the adjacent bones to promote bone growth across a joint. A successful fusion eliminates the joint and stops motion. The usual purpose is pain relief or stabilization of an undependable joint
Fusion (arthrodesis) – The joining of two bones into a single unit, thereby eliminating motion between the two. May be congenital, traumatic, or surgical.
Osteoblasts –Cells that form new bone.
Osteoclasts – Bone-resorbing cells.
Osteotomy –Literally, cutting a bone. Used to describe surgical procedures in which bone is cut and realigned
Range of motion (ROM) – The amount of movement available at a joint
Limb salvage – Surgical removal of a tumor without amputation of the affected extremity
Osteo – means bone
Chondro – means cartilage
Arthroplasty (joint replacement) – Surgical reconstruction or replacement of a painful, degenerated joint to restore mobility.
Diagnostic Tools
Computed tomography (CT, CAT scan) – A radiographic modality that allows cross-sectional imaging from a series of x-ray beams. The x-ray tube is rotated 360° around the patient, and the computer converts these images into a two-dimensional axial image. CT is capable of imaging bone in three planes: coronal, sagittal, and oblique. This modality is particularly useful in evaluating fractures and bone tumors
Magnetic resonance imaging (MRI) – An imaging modality that depends on the movement of protons in water molecules. When subjected to a magnetic field, protons that are normally randomly aligned become aligned. Radiowaves directed at the tissue to be studied are used to change the alignment of these photons. When the radiowaves are turned off, the protons emit a signal that is detected and processed by a computer into an image. In the musculoskeletal system, MRI is useful in diagnosing soft-tissue injuries, tumors, stress fracture, and infection.
Arthroscopy – visual examination of a joint.
X-ray – radiographic visualization or imagining of the internal body structures using high-energy radiation.
Physicians
Orthopaedics/Orthopedics – The medical and surgical specialty focused on treating, repairing and reconstructing the human musculoskeletal system.
Orthopaedist /Orthopaedic Surgeon – A surgeon whose specialty is treating, repairing and reconstructing the bones, ligaments and tendons of the human body.
Radiologist – Physician who specializes in study of x-rays and medicine concerned with radioactive substances
It is important to be familiar with the terms your doctor might use. I have found that so many people are intimidated and don’t ask their doctor for clarification. Hopefully these terms might help.
References
https://www.boundless.com/physiology/the-skeletal-system/lower-limb/femur-thigh/
http://www.arthroscopy.com/sp05001.htm
http://medical-dictionary.thefreedictionary.com
http://www.webmd.com/fitness-exercise/picture-of-the-achilles-tendon
http://www.bonejointcenter.com/oats-procedure.html
(http:www.scoi.com/ankle.php)
