FINGER-JOINT REPLACEMENT
F
that is found in
sickle-cell anaemia.
Swel-
ling of the fingers is also a rare feature
of tuberculosis and syphilis.
Clubbing
of the fingers is a sign of
chronic lung disease or of certain forms
of congenital heart disease. Tumours of
the finger are rare, but they may occur
in
chondromatosis
,
a condition that is
characterized by multiple noncancerous
tumours of the
cartilage
.
Congenital finger disorders include
syndactyly
(fused
fingers),
polydactyly
(extra fingers), missing fingers, or a
webbed appearance of the hand that is
caused by a deep membrane between
the fingers.
finger-joint replacement
A surgical procedure in w hich one or
more artificial joints (made of metal,
plastic, or silicone rubber) are used to
replace finger joints that have been
destroyed by disease, usually by
rheu-
matoid arthritis
or
osteoarthritis
.
HOW IT IS DONE
Usually, several finger joints are treated
at the same time. An incision is made
to expose the joint; the ends of the two
diseased bones in the joint are cut
away, along with diseased cartilage. An
artificial joint is then inserted into the
bone ends. The finger is im m obilized
in a splint until the wound has healed.
After about ten days, the dressings are
removed and the patient is encouraged
to exercise the fingers and resume nor-
mal activities.
RESULTS
Finger-joint
replacement
is
usually
successful in relieving arthritic pain
and enabling the patient to use his or
her hands again. However, it rarely
restores norm al movement.
fingerprint
An impression that is left on a surface
by the pattern of fine curved ridges on
the skin of the fingertip. These ridges
occur in four patterns: loops, arches,
whorls, and compounds
(which are
combinations of the other three). No
two people (not even identical twins)
have the same fingerprints.
first aid
The immediate treatment of any injury
or sudden illness before professional
medical care can be provided. Most
first aid consists of treating m inor in -
juries and
burns
,
and
fractures
.
Some-
times, however, emergency life-saving
first aid treatment may be needed.
The aims of first-aid treatment in an
emergency are to preserve life; to pro-
tect the individual from further harm;
to provide reassurance; to make the
victim
comfortable;
to
arrange
for
medical help; and to find out as much
as possible about the circumstances of
the accident or injury.
Various techniques can be used to
achieve these aims. For example, the
recovery position
helps to maintain an
open airway in an unconscious person
who is breathing;
artificial respiration
is
necessary if a person is not breathing.
Cardiopulmonary resuscitation
is essential
if a person is not breathing and has no
heartbeat. Heavy bleeding, w hich can
result in
shock
,
may be controlled by
applying pressure at appropriate
pres-
sure points
.
fish oil
A product occurring naturally in some
species of oily fish, such as mackerel.
Fish-oil preparations, w hich are rich in
omega
-3 fatty acids
,
are used as
lipid-low-
ering drugs
.
fissure
A cleft or groove, w hich can be either
normal or abnormal. A dental fissure is
a naturally occurring defect in the ena-
mel of a tooth in w hich tooth decay
(see
caries, dental
)
commonly arises.
The sylvian fissure is one of the deep
folds that separate the temporal lobe of
the
brain
from the frontal and parietal
lobes. An
anal fissure
is a tear occurring
in the anal canal.
fissure sealant
A substance that is bonded to the biting
surface of a tooth to seal any naturally
occurring
fissures
(clefts or grooves) in
the enamel and to help prevent tooth
decay (see
dental caries
) .
Treatment with
fissure sealant may be offered as a pre-
ventive
measure
to
children
whose
molar teeth have recently emerged (see
eruption of teeth
).
fistula
An abnormal passage leading from an
internal organ to the body surface or
connecting two organs. Fistulas may
rarely
be
congenital
(present
from
birth), or they may be acquired as a
result of tissue damage.
Congenital types include
tracheoes-
ophageal fistulas
,
branchial fistulas (see
branchial disorders
),
and
thyroglossal
fistulas (see
thyroglossal disorders
) .
Acquired fistulas may result from infec-
tion, injury, or cancer. Fistulas between
the
intestine
and the skin may occur
in the inflammatory bowel condition
Crohn’s disease
;
these fistulas may allow
the intestinal contents to escape to the
skin through an opening, in w hich case
they are known as faecal fistulas. Fistulas
of the urinary tract, w hich open from
the
urethra
or
bladder
to the perineum
(the area between the anus and geni-
tals), may be the result of
radiotherapy
to
the pelvis, or they may be caused by a
difficult childbirth. Such fistulas may
cause leakage of urine (see
incontinence,
urinary
) or
urinarytract infection
.
Certain types of
arteriovenous fistula
(between an artery and a vein) are sur-
gically constructed to provide ready
access to the circulation in people who
are having
dialysis
.
TREATMENT
Identifying the cause of a fistula, and
treating it if possible, is the first line of
action. Some types of fistula close spon-
taneously but most need surgery. In
faecal fistulas, a temporary colostomy
may be necessary to divert faeces away
from the affected area.
fit
See
seizure
.
fitness
The capacity for performing physical
activities without
exhaustion.
Fitness
depends on strength
(the
ability
to
exert force for pushing, pulling, lift-
ing), flexibility (the ability to bend,
stretch, and twist through a full range
of movements), and endurance
(the
ability to maintain a certain amount of
effort for a certain period of time).
HOW FITNESS IS ACHIEVED
Cardiovascular fitness is the precondi-
tion for all other forms of fitness; for
this reason, regular aerobic exercise
(see
aerobics
) ,
w hich makes the body’s
use of oxygen more efficient, is the
basis of any fitness programme. Speci-
fic activities, such as weight training or
yoga, can help to develop strength and
flexibility when included in a pro-
gramme (see
exercise
) .
Although fitness
training
has
cumulative
effects
that
build up over many months (provided
that there is a sustained increase in
activity levels), the effects are specific
to the muscles used and the ways in
w hich they are used. A variety of activ-
ities is therefore necessary to achieve
overall fitness.
312
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