Fractures | Cedars-Sinai

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What is a fracture?

A fracture is a partial or complete
break in the bone. When a fracture happens, it’s classified as either open or
closed:

• Open fracture (compound fracture): The bone pokes through
  the skin and can be seen. Or a deep wound exposes the bone through the skin.
• Closed fracture (simple fracture). The bone is broken, but
  the skin is intact.

Fractures have a variety of names.
Here is a list of types that may happen:

• Greenstick. This is an incomplete break. A part of the
  bone is broken, causing the other side to bend.
• Transverse. The break is in a straight line across the
  bone.
• Spiral. The break spirals around the bone. This is common
  in a twisting injury.
• Oblique. The break is diagonal across the bone.
• Compression. The bone is crushed. This causes the broken
  bone to be wider or flatter in appearance.
• Comminuted. The bone has broken into 3 or more pieces.
  Fragments are present at the fracture site.
• Segmental. The same bone is broken in 2 places, so there
  is a “floating” piece of bone.
• Avulsion. The
  bone is broken near a tendon or ligament. A tendon or ligament pulls off a small
  piece of bone.

What causes fractures?

Fractures most often happen when more force is applied to the bone than the bone can
take. Bones are weakest when they are twisted.

Bone fractures can be caused by
falls, injury, or as a result of a direct hit or kick to the body.

Overuse or repetitive motions can
tire muscles and put more pressure on the bone. This causes stress fractures. This
is
more common in athletes and military recruits.

Fractures can also be caused by
diseases that weaken the bone. This includes osteoporosis or cancer in the bones.

What are the symptoms of a fracture?

Symptoms may be a bit different for
each person. Symptoms of a broken or fractured bone may include:

• Sudden pain
• Trouble using or moving the injured
  area or nearby joints
• Unable to bear weight
• Swelling
• Obvious deformity
• Warmth, bruising, or redness

The symptoms of a broken bone may
seem like other health conditions or problems. Always see a healthcare provider for
a
diagnosis.

How is a fracture diagnosed?

Your healthcare provider will take
a full health history (including asking how the injury happened). You will also have
a
physical exam. Tests used for a fracture may include:

• X-ray. A diagnostic test that uses invisible
  electromagnetic energy beams to make pictures of internal tissues, bones, and organs
  on film.
• MRI. An imaging test that uses large magnets,
  radiofrequencies, and a computer to make detailed pictures of structures within the
  body.
• CT scan. This is an imaging test that uses X-rays and a
  computer to make detailed images of the body. A CT scan shows details of the bones,
  muscles, fat, and organs.

How is a fracture treated?

The goal of treatment is to put the
pieces of bone back in place, control the pain, give the bone time to heal, prevent
complications, and restore normal use of the fractured area.

Treatment may include:

• Splint or cast. This immobilizes the injured area to keep
  the bone in alignment. It protects the injured area from motion or use while the bone
  heals.
• Medicine. This may be needed to control pain.
• Traction. This is the use of a steady pulling action to
  stretch certain parts of the body in a certain direction. Traction often uses
  pulleys, strings, weights, and a metal frame attached over or on the bed. The purpose
  of traction is to stretch the muscles and tendons around the broken bone. This helps
  the bone ends to align and heal.
• Surgery. Surgery may be needed to put certain types of
  broken bones back into place. Sometimes internal fixation devices (metal rods or pins
  located inside the bone) or external fixation devices (metal rods or pins located
  outside of the body) are used to hold the bone fragments in place while they
  heal.

Fractures can take months to heal
as broken bones “knit” back together when new bone is formed between the broken
parts.

What can I do to prevent fractures?

Most fractures are caused by
accidents such as falls, or by other injuries. But there are some things you may be
able
to do to reduce your risk of bone fractures. These include:

• Eat a healthy diet that includes
  vitamin D and calcium to keep bones strong.
• Do weight-bearing exercises to keep
  bones strong.
• Don’t use any form of tobacco. Tobacco
  and nicotine increase the risk of bone fractures. They weaken bones and interfere
  with the healing process.
• Osteoporosis is a common cause of
  fractures in older people. Talk with your healthcare provider about your risk of
  osteoporosis. Get treatment if you have it.

When should I call my healthcare provider?

See a healthcare provider any time
you think you may have a broken bone.

An open fracture (one in which the
bone comes through the skin so you can see it or a deep wound that exposes the bone
through the skin) is considered an emergency. Get medical care right away for this
type
of fracture.

Any injury to the bones of the
spine is also a medical emergency. These cause severe back pain and may cause nerve
problems. These include numbness, tingling, weakness, or bowel and bladder problems.
Call
911 if you think someone has
a break in the bones of their spine.

Key points about fractures

• A fracture is a partial or complete
  break in the bone. There are many different types of fractures.
• Bone fractures are often caused by
  falls, injury, or because of a direct hit or kick to the body. Overuse or repetitive
  motions can cause stress fractures. So can diseases that weaken the bone.
• Symptoms include sudden pain, swelling, and trouble using or
  moving the injured area.
• The main goal of treatment is to put
  the pieces of bone back in place so the bone can heal. This can be done with a
  splint, cast, surgery, or traction.
• See a healthcare provider any time you
  think you may have a broken bone.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells
  you.
• At the visit, write down the name of a
  new diagnosis and any new medicines, treatments, or tests. Also write down any new
  instructions your provider gives you.
• Know why a new medicine or treatment
  is prescribed and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that
  visit.
• Know how you can contact your provider
  if you have questions.

Medical Reviewer: Thomas N Joseph MD

Medical Reviewer: Raymond Turley Jr PA-C

Medical Reviewer: Stacey Wojcik MBA BSN RN

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

Not what you’re looking for?

Bone Fractures: Types, Treatment & Symptoms

Overview

What is a bone fracture?

When you break a bone, healthcare providers call it a bone fracture. This break changes the shape of the bone. These breaks may happen straight across a bone or along its length. A fracture can split a bone in two or leave it in several pieces.

What types of bone fractures are there?

Healthcare providers can usually categorize a bone fracture based on its features. The categories include:

• Closed or open fractures: If the injury doesn’t break open the skin, it’s called a closed fracture. If the skin does open, it’s called an open fracture or compound fracture.
• Complete fractures: The break goes completely through the bone, separating it in two.
• Displaced fractures: A gap forms where the bone breaks. Often, this injury requires surgery to fix.
• Partial fractures: The break doesn’t go all the way through the bone.
• Stress fractures: The bone gets a crack in it, which is sometimes tough to find with imaging.

A healthcare provider may add extra terms to describe partial, complete, open and closed fractures. These terms include:

• Avulsion: A tendon or ligament pulls part of the bone off. Ligaments connect bones to other bones, while tendons anchor muscles to bones.
• Comminuted: The bone shatters into several different pieces.
• Compression: The bone gets crushed or flattened.
• Impacted: Bones get driven together.
• Oblique: The break goes diagonally across the bone.
• Spiral: The fracture spirals around the bone.
• Transverse: The break goes in a straight line across the bone.

Who gets bone fractures?

Anyone can break a bone, with certain situations making it more likely. Many people break bones from falls, car accidents and sports injuries. Medical conditions such as osteoporosis can also play a role. Osteoporosis causes at least one million fractures each year. Healthcare providers call these injuries fragility fractures.

Symptoms and Causes

What causes broken bones?

While bones are very strong, they can break. Most often, breaks happen because the bone runs into a stronger force (getting thrown forward in a car crash, say). Also, repetitive forces – like from running — can fracture a bone. Healthcare providers call these types of injuries stress fractures.

Another reason for fractures is osteoporosis, which weakens bones as you age. It’s a serious condition, so older adults should speak to a healthcare provider about their risk.

What symptoms do bone fractures have?

The symptoms of a fracture depend on which bone breaks. For example, you’ll likely know right away if you have a problem with your arm, leg or finger. If you’re not sure, consider these possible symptoms:

• Difficulty using the limb.
• Noticeable and unusual bump, bend or twist.
• Severe pain.
• Swelling.

Diagnosis and Tests

How do you test for a bone fracture?

To diagnose a broken bone, your healthcare provider will examine the injury. You will also likely have one or more imaging tests. These tests can include:

• X-rays: This tool produces a two-dimensional picture of the break. Healthcare providers often turn to this imaging first.
• Bone scan: Healthcare providers use a bone scan to find fractures that don’t show up on an X-ray. This scan takes longer — usually two visits four hours apart — but it can help find some fractures.
• CT scan: A CT scan uses computers and X-rays to create detailed slices or cross-sections of the bone.
• MRI: A MRI creates very detailed images using strong magnetic fields. MRI is often used to diagnose a stress fracture.

Management and Treatment

What broken bone treatments are there?

A healthcare provider can usually treat a broken bone with a cast or splint. Casts wrap the break with hard protection, while splints protect just one side. Both supports keep the bone immobilized (no movement) and straighten it. The bone grows back together and heals.

With smaller bones such as fingers and toes, you won’t get a cast. Your healthcare provider might wrap the injury before using a splint.

Occasionally, your healthcare provider might need to put you in traction. This treatment uses pulleys and weights to stretch the muscles and tendons around the broken bone. Traction aligns the bone to promote healing.

For some breaks, your healthcare provider may recommend surgery. Your treatment may use stainless-steel screws, plates and fixators, or frames that hold the bone steady.

Prevention

How can I prevent broken bones?

You can prevent many fractures by avoiding falls, staying in shape and getting the right vitamins and minerals.

Avoiding falls

Following certain tips can help you stay upright indoors and out.

Indoors:

• Balance: Consider balance training and physical therapy if your body feels off. Use a cane or walker if you need to.
• Clutter removal: Keep your rooms picked up. Make sure wires and cords don’t cross walkways.
• Lights: Make sure your rooms all have good lighting.
• Rugs: Use skid-free mats under any rugs you need.
• Shoes: Wear shoes – not just socks – when you’re home.
• Vision: Check your eyesight with an eye exam by an optometrist.

Outdoors:

• Attention: Pay attention to your surroundings. Watch for anything that could turn into an obstacle or cause you to trip.
• Balance: Use a cane or walker and wear rubber-soled shoes for a better grip.
• Curbs: Take care at curbs. Watch your footing as you step up.
• Lights: Leave a porch light on if you will come home after dark.
• Weather: Keep sidewalks, driveways and steps free of ice and snow. Use salt to help keep them clear.

Staying fit

Weight-bearing exercise such as walking helps keep bones healthy and strong. Exercises that build or maintain muscles can also improve balance.

Eating right

To promote bone strength, watch your diet. Make sure to get 1200 to 1500 milligrams (mg) of calcium each day. Also get 800 to 1000 international units (IU) of vitamin D. Certain foods provide good sources of these nutrients:

• Almonds.
• Beans such as chickpeas, black beans and tofu.
• Dairy such as milk and yogurt.
• Eggs.
• Vegetables such as broccoli, spinach and kale.
• Whole grains such as brown rice, oats and rye.

Outlook / Prognosis

How long does it take a fracture to heal?

Healing time for a broken bone varies from person to person and depends on the severity of the injury. For example, a broken leg will take longer than a broken arm or broken wrist. Also, you tend to heal more slowly as you age. On average, healthcare providers say it takes six to eight weeks to recover from a broken bone.

Are there complications with bone fractures?

As with many injuries, a fractured bone can lead to complications. These can include:

• Blood clots: Blockage of a blood vessel that can break free and move through the body.
• Cast-wearing complications: Can include pressure ulcers (sores) and joint stiffness.
• Compartment syndrome: Bleeding or swelling within the muscles surrounding the fracture.
• Hemarthrosis: Bleeding into the joint, causing it to swell.

Living With

When should someone see a healthcare provider for a broken bone?

If you suspect you may have broken a bone, see a healthcare provider right away. If you can’t get to urgent care or an emergency room on your own, call 911 for help.

See your healthcare provider if your treated fracture doesn’t seem to be healing. Also, see a provider if the area around the fracture swells, turns red or hurts. These signs could mean healing has hit a snag.

A note from Cleveland Clinic

Even though bones are strong, they can break. A bone fracture is painful, and you’ll want to get help with it right away. In most cases, you’ll need treatment to return to normal activity. Talk to your healthcare provider if you’re concerned about osteoporosis.

Distal Radius Fracture | Orthopedics & Sports Medicine

This is a very simple question. Unfortunately it does not have a simple answer. The kinds of distal radius fractures are so varied and the treatment options are so broad that it is hard to describe what to expect. Most fractures hurt moderately for a few days to a couple of weeks. Many patients find that using ice, elevation (holding their arm up above their heart), and simple, non-prescription medications for pain relief are all that are needed. One combination is ibuprofen (sold as a generic or under the brand names Motrin® or Advil®) plus acetaminophen (sold under the brand name Tylenol®, and also as a generic, often marked on the box “non-aspirin pain reliever”). The combination of both ibuprofen plus acetaminophen is much more effective than either one alone (the medical term for this is synergistic). If pain is severe, patients may need to take a prescription strength medication, often a narcotic, for a few days. Discuss these options with your doctor.

Casts and splints must be kept dry, so use a plastic bag over your arm while you are showering. If you do get it wet, it will not dry very easily (you can try to use a hair dryer on the cool setting). There are no real “waterproof” casts, but there are some options available that have their pluses and minuses. Discuss this with your doctor.

Most surgical incisions must be kept clean and dry for five days or until the sutures (stitches) are removed, whichever occurs later.

Everyone wants to know, “Can I return to all my former activities, and when?” This is a great question that also seems rather simple and straightforward, but the answer is complex. Most patients do return to all their former activities, but what will happen in your case depends on the nature of your injury, the kind of treatment you and your surgeon decide upon, and how your body responds to the treatment. You will need to discuss your case with your doctor for the specifics of your case, but some generalizations can be made.

Most patients have their cast taken off at about six weeks.

Most patients will start physical therapy, if their doctor feels it is needed, within a few days to weeks after surgery, or right after the last cast is taken off.

Most patients will be able to resume light activities such as swimming or working out the lower body in the gym within a month or two after the cast is taken off, or after surgery.

Most patients can resume vigorous physical activities, such as skiing or football, between three and six months after the injury.

Almost all patients will have some stiffness in the wrist, which will generally diminish in the month or two after the cast is taken off or after surgery, and will continue to improve for at least two years.

You should expect your recovery to take at least a year. You will still feel some pain with vigorous activities for about that long. Some residual stiffness or ache is to be expected for two years or possibly permanently, especially for high energy injuries (such as motorcycle crashes, etc.), in patients over 50, or in patients who have some osteoarthritis. However, the good news is that the stiffness is usually minor and may not affect the overall function of the arm.

Remember, these are general guidelines and may not apply to you and your fracture. Ask your doctor for specifics in your case. Your doctor knows that returning to activities is important to you.

Finally, osteoporosis is a factor in as many as 250,000 wrist fractures. It has been suggested that people who suffer a wrist fracture may need to be screened for osteoporosis, especially if they have other risk factors. Ask your doctor if you need to be screened or treated for osteoporosis.

Information provided by the American Society for Surgery of the Hand.

SEE: What broken bones look like

Our bones are the basic framework of our bodies and we use them for almost every imaginable activity. When we speak, we use our jawbone, and when we walk we use the bones in our feet and knees. All 206 bones in our body are involved in the delicate mechanics of physical movement.

Some activities, however, place more strain on our bones and can result in fractures. Sport, especially contact sport, often leads to broken bones. Just this weekend, Springbok prop Julian Redlinghuys suffered a frightening injury during which he sustained a “neck dislocation”.

WATCH: 3 worst injuries of 2016 Olympics thus far

Although not falling purely into the category of broken bones, this case does put the spotlight on sports injuries. After a sports injury people often ask: “What does a broken ankle look like?” or “Can you actually see when an arm is broken?” We searched the web to show you what broken bones look like.

Broken ankle

There is often confusion between a “fracture” and a “broken bone”. According to the American College of Foot and Ankle Surgeons a fracture is a partial or complete break in a bone. The concepts are therefore used interchangeably by medical experts, and it’s only the degree of severity that separates the two.

Ankle fractures are common injuries and are often caused by the ankle rolling inward or outward during sporting activities.   

According to the American College of Foot and Ankle Surgeons, the following symptoms are characteristic of a broken ankle.

• Pain at the site of the fracture, which can extend from the foot to the knee.
• Significant swelling, which may occur along the length of the leg, or may be more localised.
• Bruising that develops soon after the injury.
• The broken ankle will look different compared to the other ankle.
• If there is any bone protruding through the skin, immediate medical attention is required.

GRAPHIC: To see what a protruding bone in the ankle looks like, please click here. Beware: The image you are about to see is graphic and may upset sensitive people.

Take a look at how this ER doctor twisted this guy’s ankle back after a bicycle accident:

Wrist

The wrist can be fracture in many different ways, and is most often referred to as a distal radius fracture.

According to the research organisation Radiopedia, a Colles’ fracture is an example of such a fracture and “a very common extra-articular fracture of the distal radius that occurs as the result of a fall onto an outstretched hand”.

Here’s an X-ray image of a fractured radius showing the characteristic Colles’ fracture with displacement and angulation of the distal end:

                                                                                                  ^Wikipedia

And on this image the deformity in the wrist can clearly be seen:

                                                                    ^Wikipedia

Broken arm

According to the Mayo Clinic, a broken arm “involves one or more of the three bones in your arm – the ulna, radius and humerus”. This is a very common sports injury and usually happens when someone or something falls unto an outstretched hand.

Here’s an X-ray of a broken arm. It’s clear on the left-hand side where the bone is broken:

                                                                              ^iStock

And here are the internal and external views of a fractured arm, before and after surgery:

                                                                       ^Wikipedia

Read more:

Fun spring exercises to build bone density

These bones were made for walkin’

Beef up your bones

Broken Hand (Metacarpal Fracture) — Bone Talks

What is the long term outcome?  

Why is it so important to straighten out the bone? 

If a metacarpal heals excessively bent, it will develop clawing of the fingers (actually its called “pseudoclawing”) by changing the biomechanics of the finger tendons (the fingers will extend at the MCP joints to compensate for the MC head which is flexed into the palm, this will increase the tension of the finger flexors and give the finger a sort of claw like appearance.)  

Additionally, the bent bone will be felt as a hard bump in the palm of your hand.  This can prevent full grip strength.  

Lastly, if the finger is rotated, then when you make a fist, the finger will tuck under the others causing an uncomfortable grip. 

Once the cast comes off or the pins come out (depending on the treatment), you need to start moving the finger to prevent stiffness.

Oftentimes people will meet with a hand therapist to review exercises to do every day to prevent this stiffness.  Full recovery depends on the patient and the severity of injury. Usually the pain will subside within the first two weeks. The pain from the bones rubbing together will stop because the body has formed a callus, or a shell around the fracture to hold everything in place and to bridge the gap with new bone. 

Hand function starts to approach near normal in about 2 months, however, it can take up to 6 months to truly feel like your hand is back to its old self after this injury.

Reference

1. Elfar J, Mann T. Fracture-dislocations of the proximal interphalangeal joint. JAAOS 2013; 21: 88-98. full article. review

2. Chung KC, Spilson SV: The frequency and epidemiology of hand and forearm fractures in the United States. J Hand Surg Am 2001; 26:908-915.  see article. general facts. pinky finger is 40% of hand injuries, then other 4 get equal distribution. prox phalanx most injured, then distal then middle. 

3. Dabezies EJ, Schutte JP: Fixation of metacarpal and phalangeal fractures with miniature plates and screws. J Hand Surg 1986;11:283–288. see article. 90% normal ROM in 25 MC and 27 phalanx fx after ORIF.  good outcome data.

4. Page SM, Stern PJ. Complications and range of motion following plate fixation of metacarpal and phalangeal fractures. J Hand Surg 1998;23: 827–832.  see article. 100 MC, 100 phalanx fx after ORIF, only 76% got >200 deg motion for MC (but only 11% in phalanx fx). plate req. inc soft tissue dissection, tissue adheres to plate.

5. Diwaker HN, Stothard J. The role of internal fixation in closed fractures of the proximal phalanges and metacarpals in adults. J Hand Surg Br 1986; 11:103–108. see article. compared 50 k-wire and orif vs 50 nonop rx. orif best motion (80% got 200 deg motion) vs only 50% in k-wire, nonop.  

6. Botte MJ et al. Complication of smooth pin fixation of fracture and dislocation in the hand and wrist. CORR 1992: 276:194-201. see article. complications w. K-wire: 18% overall: 7% infxn; 5% nonunion, 4% pin loosening.  main concern k-wire is osteomyelitis and lost reduction, extensor mech tethering.  

7. Galanakis I et al. Treatment of closed unstable metacarpal fractures using percutaneous transverse fixation with Kirschner wires. J Trauma 2003; 55:509-513. see article. pin to neighboring MC, one prox, two distal. keep for 4 wks (3 isnt enough).  good outcomes.  

8. Henry MH. Fractures of the Proximal Phalanx and Metacarpals in the Hand: Preferred Methods of Stabilization. JAAOS 2008; 16: 586-595. see article. eview. 

Rare Isolated Trapezoid Fracture: A Case Report

Hand (N Y). 2008 Dec; 3(4): 372–374.

and

Rita M. Sadowski

University of Massachusetts Medical Center, 55 Lake Avenue North, Worcester, MA 01655 USA

Richard D. Montilla

University of Massachusetts Medical Center, 55 Lake Avenue North, Worcester, MA 01655 USA

University of Massachusetts Medical Center, 55 Lake Avenue North, Worcester, MA 01655 USA

Corresponding author.

Received 2008 Feb 3; Accepted 2008 Mar 20.

Copyright © American Association for Hand Surgery 2008This article has been cited by other articles in PMC.

Abstract

Isolated fractures of the trapezoid are rare. Of all of the fractures of the carpus, the most common is the scaphoid, which represents 68.2% of all carpal fractures (Papp, Orthop Clin N Am 38:251–60, 2007). In contrast, trapezoid fractures represent 0.4% of all carpal injuries. Because it is an infrequently fractured carpal bone, there is a wide variety of treatment plans, including rest, immobilization, and surgery (Green and Pederson, Green’s Operative Hand Surgery, Elsevier, Philadelphia, 759 pp, 2005). In this report, we describe a patient who presented with an isolated fracture of the trapezoid that was successfully treated with cast immobilization and had a full functional recovery.

Keywords: Trapezoid, Fracture, Carpal, Wrist, Hand surgery

Case Report

The patient was a 19-year-old right hand dominant male who presented to our facility 2 1/2 weeks after his injury. On the date of injury, the patient was roughhousing with a friend and, while trying to punch him, he hyperextended his right wrist and then heard a crack. He subsequently sought treatment from his primary care physician (PCP) 3 days later because of persistent pain and swelling. Three-view radiographs of the wrist did not show a fracture. The patient was given a wrist lacer splint for comfort.

In a follow-up visit with his PCP, the patient continued to complain of wrist pain especially with range of motion. A computed tomography (CT) scan with 3-D reconstruction of the right wrist was obtained. It showed an isolated comminuted fracture of the trapezoid, and the patient was sent to the hand surgery clinic for consultation.

On physical examination of the affected right upper extremity, the patient had moderate swelling of the dorsal and volar surfaces of the wrist. There was tenderness to palpation at the base of the second metacarpal. Because of pain, the patient had limited wrist flexion, wrist extension, and radial–ulnar deviation. He had no crepitus or clicking on range of motion. He had full finger flexion and no extension lag. CT scan of the right wrist showed a nondisplaced proximal comminuted trapezoid bone fracture.

The patient was placed in a short arm cast for 6 weeks with the wrist in 20° of extension and the metacarpophalangeal and interphalangeal joints free and then progressed to a splint for the next 2 weeks. He also began hand therapy, which included passive and active range of motion.

After 8 weeks, the pain and swelling resolved completely and he recovered his range of motion. He was eventually able to return to his job in construction. He completed physical therapy with 68° of wrist extension on the right and 65° on the left. He had wrist flexion of 90° on both the right and left. Radial deviation was 35° on the right and 40° on the left. Ulnar deviation was 35° on both the right and left. He had an extremely symmetric wrist in terms of function between the injured and noninjured wrists. In a follow-up with the patient 8 months later, the patient stated that he remained pain-free and continued to be employed in construction.

Discussion

The trapezoid is the least commonly fractured carpal bone [8]. The anatomy of the trapezoid places it in a fairly protected position. Distally, it forms a stable, relatively immobile joint with the second metacarpal [4]. From this point, it is bound by strong ligaments to the trapezium radially, the capitate ulnarly, and the scaphoid proximally. Its shape is like a keystone, and it is two times wider dorsally than palmarly [2]. Gelberman and Gross showed that although the trapezoid has multiple sources of blood supply, it lacks internal anastamoses [3]. Osteonecrosis of the trapezoid has been reported; however, it is less common than osteonecrosis of the scaphoid [10].

Injury to the trapezoid can occur through axial force applied to the second metacarpal base. In our patient’s case, it appears that axial loading in addition to wrist hyperextension occurred when the patient delivered a punching blow. Fracture–subluxations are not uncommon. In these injuries, the force causes palmar flexion of the index metacarpal and displaces the trapezoid dorsally and proximally. Although closed reduction and percutaneous pinning can be attempted to reduce and fix these fracture–dislocations, open reduction and internal fixation may be necessary. Direct trauma to the metacarpal base, rather than axial compression, can also produce a trapezoid fracture.

Patients with trapezoid fractures complain of pain at the base of the second metacarpal. They may also complain of pain in the region of the snuffbox [5]. On physical exam, they can have wrist swelling and decreased range of motion of the wrist because of pain. Unfortunately, these fractures can be difficult to identify with plain radiography because of both overlapping bones which obscure the fracture line and the fragment size, as in our case. Such fragments are also rarely displaced because of the intercarpal and carpometacarpal ligaments that support them. Brismar found that zero of ten patients with a positive bone scan for a trapezoid fracture had evidence of the fracture on plain radiograph [1]. Waizenegger found that out of 84 patients with snuffbox pain and normal radiographs, six had fractures of the trapezium or trapezoid [11]. For this reason, special oblique and carpal tunnel views have been recommended. Bone scans, magnetic resonance imaging, and CT are useful adjuncts to attaining a definitive diagnosis and provide greater information regarding the nature of the fracture and can assist with the formulation of a treatment plan.

Because of the rarity of isolated trapezoid fractures, a standard treatment has not been established. There have been three other cases reported of truly isolated trapezoid fractures [5–7]. In addition, in the last two decades, there have been three additional case reports of trapezoid fracture as part of more global hand and wrist injuries [9, 12, 13]. Satisfactory treatment patterns have included cast immobilization, open reduction and internal fixation, and excision of smaller displaced fragments. Displacement of up to 2 mm has been successfully treated nonoperatively [5]. Nonunion of the trapezoid has been successfully treated with open reduction, internal fixation, bone grafting, and excision of the small comminuted fragments.

In summary, we treated a rare case of isolated fracture of the trapezoid with cast immobilization. Subsequent clinical visits showed resolution of pain and achievement of full recovery of wrist function and return to work.

References

1. Brismar J. Skeletal scintigraphy of the wrist in suggested scaphoid fracture. Acta Radiol 1988;29:101–7. [PubMed]2. Cohen M. Fractures of the carpal bones. Hand Clin 1997;13(4):587–99. [PubMed]3. Gelberman G. The vascularity of the wrist. Clin Orthop Relat Res 1986;202:40–9. [PubMed]

4. Green H, Pederson W. Green’s operative hand surgery. Philadelphia: Elsevier; 2005. 759 p.

5. Jeong GK, Lester B. Isolated fracture of the trapezoid. Am J Orthop 2001;30:228–30. [PubMed]6. Miyawaki T, Kobayashi M, Matsuura S, Yanagawa H, Imai T, Kurihara K. Trapezoid bone fracture. Ann Plast Surg 2000;44:444–6. [PubMed]7. Nagumo A, Toh S, Tsubo K, Ishibashi Y, Sasaki T. An occult fracture of the trapezoid bone: a case report. J Bone Joint Surg Am 2002;84:1025–7. [PubMed]8. Papp S. Carpal bone fractures. Orthop Clin N Am 2007;38:251–60. [PubMed]9. Pruzansky M, Arnold L. Delayed union of fractures of the trapezoid and body of the hamate. Orthop Rev 1987;16(9):624–8. [PubMed]10. Rhoades CE, Reckling FW. Palmar dislocation of the trapezoid. J Hand Surg 1983;8(1):85–8. [PubMed]11. Waizenegger M, Wastie ML, Barton J, Davis TRC. Scintigraphy in the evaluation of the “clinical” scaphoid fracture. J Hand Surg Br 1994;19B(6):750–3. [PubMed]12. Watanabe H, Hamada Y, Yamamoto Y. A case of old trapezoid fracture. Arch Orthop Trauma Surg 1999;119:356–7. [PubMed]13. Yasuwaki Y, Nagata Y. Fracture of the trapezoid bone: a case report. J Hand Surg Am 1994;19A(3):457–9. [PubMed]

Scaphoid Fractures

The wrist is made up of eight bones. The wrist bone below the base of the thumb is known as the scaphoid bone. A fracture (break) of this bone can happen when a person falls onto the outstretched hand. This type of fracture does not happen very often in young children because this bone is mostly cartilage. It is seen more often in young adolescents. As more children participate in intense sports activities, this fracture is seen more often.

A person with a scaphoid fracture typically has pain at the wrist. Following a wrist injury, x-rays of the wrist will be taken. Right after a wrist injury, x-rays of the wrist may not show a scaphoid fracture. The provider may still place your child in a cast due to concern for an occult or ‘hidden’ fracture. X-rays will be taken at each follow-up visit; it is not unusual to discover a fracture where it was not clearly seen before.

Symptoms

Your child may have swelling and bruising around the wrist. He or she may complain of pain when moving the wrist as well.

Diagnosis

X-rays of the wrist are taken to see if a fracture is present
(Picture 1). This scaphoid fracture would be called a waist fracture based on its location in the middle third of the bone.

If the fracture is located in the bottom third of the bone it is known as a ‘proximal pole’ fracture.

On the top third of the bone, it is a ‘distal pole’ fracture.
Where it is located will play a role in the treatment plan of
the fracture.

The provider will also do a physical exam
to check for swelling, bruising, pain and
range of motion. One area to check for
pain is the “anatomic snuffbox,” shown
in Picture 2. Pressing over this area puts
pressure directly on the scaphoid bone.
If there is pain at this area, the provider
will presume there is a scaphoid fracture,
even if it does not show on the x-ray.

Nonsurgical Treatment

A scaphoid fracture will need at least six weeks
of immobilization in a cast, but often longer.
We typically use a waterproof cast if no surgery is needed. We plan to see your child every four weeks to remove the cast, look at the skin, and get new x-rays. Depending on healing, he or she will be placed back in a cast or changed to a Velcro brace. Ninety percent of these fractures will heal with cast treatment, but it may take as long as three months, depending on fracture location.

Nonunion

A scaphoid fracture nonunion is when the
bone pieces fail to heal together. Typically
this occurs because of a missed or delayed
diagnosis.

A nonunion can also lead to avascular
necrosis (AVN), when a lack of blood
supply to a bone causes it to die. AVN
can lead to early arthritis in the wrist.
Blood flow to the scaphoid bone occurs
via retrograde (‘backwards’) flow, meaning
blood enters at the distal (top) portion of
the bone and there is no direct blood supply
to the proximal (bottom) portion of the bone.
This retrograde blood supply is what can cause
a fracture nonunion to go on to AVN
(Picture 4).

Surgical Treatment

Some scaphoid fractures will need surgery to help them heal, especially those in the proximal pole or scaphoid nonunions. Surgical complications can include, but are not limited to:

• Bleeding
• Infection
• Harm to surrounding structures
• Nonunion (bone pieces do not
  heal together)
• Malunion (bones heal in wrong position)
• Hardware complications (screw breaks)
• Failure of fixation (fracture moves)
• Stiffness
• Wound healing problems
• Avascular necrosis (bone death)
• Need for further surgeries

This surgery is known as an open reduction and internal screw fixation. The surgeon will make an incision (‘cut’) at the wrist and insert a special compression screw to push the two pieces of bone together. Since there is no direct blood flow to the bottom piece of the scaphoid bone, pushing these pieces back together with the compression screw helps to direct blood flow to the bottom piece. This screw will stay in place for the person’s entire life. See Picture 5 for a before and after example of a scaphoid fracture that required surgery.

Sometimes a bone graft (piece of bone) is taken from the radius (forearm bone) to fill in the fracture of the scaphoid bone. The wrist is immobilized in a splint after surgery. Just as discussed before, these types of fractures need a splint known as a thumb spica splint.

The first follow-up is two weeks after surgery. The splint is removed and x-rays are taken. If the wound is healing well, the child will get a waterproof cast. Your child will continue to follow up in clinic every four weeks until sufficient healing is seen.

Some people benefit from the use of a bone stimulator. This is a device that can work through the cast to give off ultrasound waves that stimulate new bone to form.

The provider may order a CT scan to get a 3-D image of the bone. This shows how the healing is progressing. It helps to decide when we can stop casting and allow the child to return to normal activities with no restrictions.

When to Call the Clinic

Contact the orthopedic clinic if any of these things occurs:

• The splint or cast gets soiled, wet, or starts falling apart.
• Fingers are not pink and warm.
• Your child is crying more than usual or is in pain.
• Your child has a fever over 101^oF after surgery.

Clinic Contact Information

• Clinic hours are Monday through Friday, 8:00 a.m. to 4:30 p.m.The phone number is (614) 722-5175. Ask for the nurse to discuss any symptoms.
• Evenings, weekends and holidays phone (614) 722-2000. Ask for the Orthopedic Resident on call to discuss any symptoms.

Be sure to contact the clinic if you cannot keep any follow-up appointments.

Scaphoid Fractures (PDF)

HH-I-439 6/18 | Copyright 2018, Nationwide Children’s Hospital

How to properly bandage your hands with boxing bandages. The method of professional boxers.

Learn to bandage properly to increase impact force and prevent injury. The method used by boxers at Fredy Roach’s Wildcard Boxing.

Why bandage your hands at all?

Hands are the most important weapon of a boxer. They are made up of many small bones and tendons that are easily damaged. Boxing wraps keep your wrist, fingers, knuckles together and hold them together.

Many people incorrectly think that this is just additional protection for the knuckles. This is not the case, there are boxing gloves to protect the fist. Bandages, in this way, tighten the hand so that the shock arising from the impact causes as little damage as possible.

If the hands are improperly bandaged, or there are no boxing bandages at all, then there is a high risk of fracture of the small bones of the wrist. Even if they do not break, then various inflammations are possible, which will not allow you to do your usual homework, type on a computer, hold a pen.In general, believe me – these are very painful and, most importantly, long-term healing injuries. Save your hands for life after boxing)

How to bandage hands

You will need a pair of boxing bandages. I like the 4.5m length, but shorter lengths can be used.

So let’s get started!

1. Place the loop over your thumb and start bandaging OVER your hands. In the future, always stick to the direction from the thumb.

This is NOT NECESSARY!

2. Three times around the wrist

This provides brush support. If you have short bandages or large arms, you can do two turns.

3. Then three times around the palm

Just wrap your hand. No need to climb on the knuckles

At the end, return to the base of the thumb.

4. Three X thru fingers .

Now you need to draw an X in the palm of your hand with a boxing bandage that goes between your fingers. This part of the winding will allow the knuckles to be gathered into a fist while protecting them from damage.

Start with the little finger and ring finger.

Now from the inside towards the big

Then go down to the base of the fist.From the inside of the wrist, bring it under the thumb. Boxing bandage formed a kind of X.

Then up again. Between ring and middle fingers

The second X is formed.

Back up. Let’s take care of the hollow between the middle and forefinger.

We finish the third X according to our technology. All fingers are bandaged correctly!

We were under the thumb.

5. Wrap the thumb

Wrap once around the wrist

We find ourselves from the outer edge of the palm

6. Strengthen the thumb

We pass the bandage outside and go down on the palm.

We shake the palm. This will allow us to attach our thumb to the entire fist structure, which minimizes the possibility of injury.Notice that the bandage has changed direction to thumb.

7. Three times around the knuckles

Wrap the bandage over the knuckles.

8. Is there a bandage left?

If you still have a bandage, you can make an additional “X”

OR

You can swing the knuckles a couple of times.

We finish at the wrist.

Helpful Hints When Winding Boxing Bandages

· You should be comfortable. The hand is relaxed, but when it is clenched into a fist, the bandages are pulled. If, after 30 minutes, you feel pain or your fingers turn white, then most likely the bandages have been pulled over.

· Wrap the wrist tightly or loosely. It all depends on your preferences. Personally, I love it when the wrist is well tightened. However, many people like mobility, for high-quality hooks and uppercuts.

Be sure to protect your hands! And you can always buy boxing bandages from us! In the boxing store Rocky-shop.ru

90,000 radial fracture with and without displacement / dislocation / fracture – Treatment and rehabilitation

The radius of the hand is a long, tubular, immobile paired bone in the forearm, the body of which has a triangular shape with three surfaces (anterior, posterior and lateral) and three edges (anterior, posterior and interosseous).It is located next to the ulna, so they are dependent on each other and interconnected. At the bottom, these bones connect to the bones of the wrist. This is how the wrist joint is formed. Also, the radius is responsible for the mobility of the forearm in the elbow, and the shoulder in the shoulder joint. But according to statistics, with almost the same structure and anatomy, the radius breaks much more often than the ulna.

Types of damage

List of diseases and injuries associated with the radius:

• Inflammation of the periosteum of the radial bone , as a result, the nutrition of bone tissue can be seriously impaired, which can lead to a gradual destruction of the bone
• Degenerative lesions of the articular surface is a process of thinning of cartilage tissue from excessive loads (sports, hard work), as a result of which damping and sliding in the joint deteriorates, more and more friction arises, leading to joint destruction
• Osteomyelitis – a disease that affects all the tissues that make up the radius (periosteum, bone itself and bone marrow)
• Fractures .

Classification of fractures of the radius:

• Traumatic and pathological (depending on the nature of the occurrence)
• Closed and open (depending on the violation of the skin)
• Oblique, longitudinal, transverse, T-shaped, helical, impacted (in which bone fragments enter (“hammer”) into each other) and comminuted (depending on the fault line)

Any type of fracture can be with or without displacement of bone fragments.A fracture of the radius without displacement most often occurs in the form of a crack in the bone tissue.

It is important to know that diseases and injuries of the radius are often accompanied by similar diseases of the ulna, so if problems with one bone are found, the other should also be examined.

Symptoms

The clinical picture of fractures of the radius is as follows:

• The onset of severe pain from the wrist to the elbow
• Edema and swelling
• Hematoma is possible (but not always)
• With displaced fractures, a characteristic crunching sound may appear on palpation of fragments and a visible deformity of the wrist joint
• Numbness of fingertips
• Movement in the wrist joint is limited

Which doctor should I contact

In the event of a serious injury, the victim should be immediately taken to the trauma department, where he will be provided with qualified medical care.

Experts who will help you:

Diagnostics

Diagnostics for injuries of the radius includes:

• Interviewing the patient about the circumstances of the injury
• Initial medical examination
• Radiation diagnostics:

Treatment options

Key methods of fracture treatment: conservative and surgical.

Conservative treatment is prescribed for closed fractures without displacement and is the application of an immobilizing plaster cast on the injured area after the edema subsides.Together with this, the doctor prescribes the intake of pain relievers, anti-inflammatory nonsteroidal drugs and, if necessary, antibiotics. The timing of uncomplicated fracture healing varies from 4 to 5 weeks. After removing the plaster, the doctor prescribes rehabilitation treatment.

Surgery is necessary for displaced fractures and comminuted fractures. The main goal of all therapeutic measures is to restore the functionality of the injured hand (as it was before the injury).

The main treatment for fractures is reduction. The essence of the method consists in returning the displaced fragments of the radius to their original places and their further fixation. Reduction can be closed and open. Open reduction involves making an incision at the site of injury, matching bone fragments and fastening them with special structures (pins, distraction devices (for example, the Ilizarov apparatus), plates). This operation is called osteosynthesis.

After removing the plaster cast, a rehabilitation course is prescribed, which is individual for each patient. Rehabilitation may include: physiotherapeutic procedures (electrophoresis, UHF, paraffin therapy, etc.), hand massage, physiotherapy exercises (with a special complex of restorative physical exercises), adherence to the diet recommended by the doctor.

To make an appointment with specialized specialists in Moscow, you are invited to the clinic of the Central Clinical Hospital of the Russian Academy of Sciences.

90,000 Five best pranks for the first of April – Rossiyskaya Gazeta

Making fun of a friend or colleague is the sacred duty of everyone who celebrates April Fool’s Day. How to do this and not be known in your department as a vulgar and a person without a sense of humor? There are some simple but little known ways.

1. Help from Igor Nikolaev

Forget sticking the mouse with opaque paper – this is the last century. It is better to install an extension for Chrome called iNikolayev, which replaces all the pictures on the pages with Igor Nikolaev’s photos.

2. Fake desktop

This advice came to us from across the ocean. The editors of the International Business Times recommend pranking colleagues as follows: take a screenshot of the victim’s desktop, then save this image to a file and open the file in some kind of “viewer”. After that, it remains to observe how a colleague tries to open the “Start” menu or click on the shortcut.

By the way, you can also set the “blue screen of death” or the DOS start screen as such a “splash screen” – this will be especially appreciated by Windows users.For those using Mac OS X, you can set the Windows Metro tiled interface as your screensaver or screensaver.

3. Left-handed and right-handed

A simple but effective prank is to swap the assignments of the mouse buttons. The right button will open programs, and the left button will bring up a context menu. Just do not forget to tell the victim in five minutes what the matter is. Otherwise, the first of April may end for you in the traumatology department.

4. Cracks on the glass

A simple smartphone app called Crack Your Screen Prank brings up a pretty compelling picture of cracked glass on the screen.Many people believe. You can customize the appearance of cracks depending on the action – when touched, shaken, or after a certain time.

Another fun way to prank a person using your smartphone is to make him think that you are constantly typing a message. To do this, you just need to save a small picture in the memory of your device and then send it to the addressee, having previously written “Hey” or “Hello” in the chat.

Surgical interventions in the treatment of fractures of the olecranon (ulna) in adults

Surgical treatment of olecranon fracture

The bony tip of the elbow is called the olecranon.It is shaped to bend and straighten the arm at the elbow joint. The olecranon is located just under the skin of the elbow, making it vulnerable to injury and fracture (tear) from falls. When this happens, people sometimes cannot straighten their arms. Treatment for this fracture usually involves surgery to restore the position of the broken parts of the bone, and then further fix them with wires, pins, plates, screws, and other devices.

Description of studies included in the review

We searched the medical literature through September 2014 and found 6 studies that included 244 adults with an olecranon fracture.Each trial made different comparisons. Tie-loop fixation, which is a commonly used method of fixing these fractures, was a ‘control’ intervention in five trials.

Quality of evidence

All six tests were small and had flaws that could affect the reliability of their results. We rated the overall quality of the available evidence for each comparison as either low or very low.

Summary of Evidence

One trial compared the use of plate fixation with tightening loop fixation. It found that more people were able to move their elbows painlessly after being fixed with the plate and fewer people felt the discomfort of the metal protrusion, which is a well-known problem with wire fixation, where a metal wire on the surface of the bone just under the skin causes pain, discomfort, and other problems.

Four trials compared different types of wire fixation. The two trials found very little clear evidence of any difference between the two. One study has shown that the addition of an intramedullary screw (a screw that is inserted through the bone and along the central canal of the bone) to standardize lash loop fixation reduces the risk of under-skin hardware being visible. Another study showed that the cable-rod system improved function and resulted in fewer complications compared to standard lashing loop fixation.

Finally, one study compared a new anchorage with a titanium-nickel device that, after implantation, takes the shape of an olecranon with a locking plate. It found no clear evidence of differences between these methods in terms of joint function data and complications obtained by interviewing patients (there was only one complication – superficial infection).

Conclusions

There is insufficient evidence at this time to determine with certainty the best treatment for these fractures.Further high quality research is needed and is likely to have a profound effect on our confidence in our estimates of effects and is likely to change our estimates.

“Leonid Ilyich was lying on his back”: how the USSR was full of rumors about an attempt on Brezhnev’s life – Politics

At the end of March 1982, rumors spread around Moscow: an attempt was made on 75-year-old Brezhnev, he is dying. Even the version that the General Secretary of the Central Committee of the CPSU had already died was seriously discussed, but they did not advertise the death because of the fierce struggle of his comrades-in-arms for his chair.

Brezhnev was removed from the plane that had flown in from Tashkent, he could not stand on his feet, and straight into the ambulance. That’s why everyone was surprised: the departure from Tashkent was shown on TV (“Time”), but the arrival in Moscow was not. They say that at the time when he was supposed to be taken from Vnukovo to the hospital, passers-by on the streets were “asked” to go to the courtyards, to the entrances

Anatoly Chernyaev

Deputy Head of the International Department of the CPSU Central Committee. From diaries

They did not know all the details even on Staraya Square, where the party’s Central Committee was located.The deputy head of the International Department of the Central Committee Anatoly Chernyaev wrote in his diary in those days: “Brezhnev was taken off the plane that had flown from Tashkent, he could not stand on his feet, and straight into the ambulance, on Granovsky. TV (“Time”), but no arrival in Moscow. the mind is incomprehensible. ”

Fatal Bounty

The visit to Tashkent was really not the best way for the Secretary General.

Leonid Brezhnev was not in the best physical condition, but the reason – the awarding of the Order of Lenin to Uzbekistan for achievements in the national economy – demanded the presence of the head of the Communist Party. The program was intense: before the ceremonial meeting in Tashkent, Brezhnev and the first secretary of the Central Committee of the Communist Party of Uzbekistan Sharaf Rashidov were to visit several large enterprises, including the Chkalov Aviation Plant, where Il-76MD military transport aircraft were assembled.

Leonid Brezhnev in Tashkent a few hours before the incident

© Vladimir Musaelyan, Eduard Pesov / TASS

At some point, the aircraft plant was struck out of the program, having decided that there was not enough time.Brezhnev noticed this and in an ultimatum demanded to take him to a planned meeting with the workers. The head of the personal guard, General Alexander Ryabenko, tried to dissuade him from going, but the secretary general insisted on his own. The plant’s management notified the workers that the meeting with Brezhnev would still take place. All and sundry rushed to the assembly shop. According to the estimates of the security personnel, about 15 thousand people gathered in and around the building.

Trouble began immediately: the escort car failed to break through the crowd at the gate of the workshop.Brezhnev moved slowly in a tight circle of workers, the guards tried to convince him to return, but the secretary general walked slowly forward. The scaffolding erected along the fuselages of the aircraft under construction was crowded with people.

The system collapsed and crushed the leader

Brezhnev’s bodyguard, Vladimir Medvedev, described what was happening in his memoirs: “Leonid Ilyich was almost already out from under the plane when suddenly there was a grinding sound…. People rolled down an incline towards us. The forests have crushed many. I looked around and did not see either Brezhnev or Rashidov, together with those accompanying they were covered with a collapsed platform. “

Leonid Ilyich was lying on his back. With the corner of a metal cone, his ear was peeled off, blood was flowing. A serious injury, as it turned out later, was received by the head of the local “nine”, and Rashidov was also hooked.

Vladimir Medvedev

Leonid Brezhnev’s personal guard. From memories

When the scaffolding was raised, the guards saw the following picture: “Leonid Ilyich was lying on his back,” Medvedev recalled.- Next to him is Volodya Sobachenkov (one of Brezhnev’s bodyguards. – TASS ). With a broken head. Dr. Kosarev and I raised Leonid Ilyich. With the corner of a metal cone, his ear was peeled off, blood was flowing. They helped Volodya Sobachenkov to get up, he did not lose consciousness, but his head was covered in blood … As it turned out later, the head of the local “nine” got a serious injury, and Rashidov was also hooked. “

Dr. Kosarev asked if Brezhnev could go, in response, the secretary general complained of pain in the collarbone.Cars were summoned to the workshop, but the crowd did not allow to pass. Then General Ryabenko drew his pistol and began to pave the way to the car. This is the only way to evacuate the victims from the aircraft plant.

After the incident at the aircraft plant, Leonid Brezhnev could not raise his hands even for applause. In the photo – a ceremonial meeting in Tashkent, March 25, 1982

© Vladimir Musaelyan / TASS

X-rays showed Brezhnev’s right collarbone fracture, but the secretary general flatly refused to return to Moscow.He was to hold several more official events, including delivering a long speech at a solemn meeting and pinning the Order of Lenin on the banner of the republic.

When the delegation returned to the capital, the doctors discovered the dislocation of the broken collarbone. Because of heart problems, they were afraid to do the operation under general anesthesia, and the secretary general went to bed for a long time in the hospital on Granovsky Street. According to the experienced courtier, academician of medicine Yevgeny Chazov, “everyone was doing a good face at a bad game, pretending that nothing was happening to Brezhnev.”

In fact, after the incident in Tashkent, Brezhnev never recovered until his death. And this state of his exacerbated the struggle for power in the top of the Communist Party.

The split of the Brezhnev “guard”

At that moment in the leadership of the CPSU there were several groups preparing to replace Brezhnev “their” candidate. Konstantin Chernenko and Yuri Andropov fought most actively for power, and did not write off the head of the Central Committee of the Communist Party of Ukraine, Vladimir Shcherbitsky, who was close to Brezhnev.

All intrigues were hidden from the public, and who was the current favorite with the ailing general secretary was judged by circumstantial evidence. On April 22, Brezhnev appeared in public for the first time after the incident in Tashkent – at a ceremonial meeting in the Kremlin dedicated to the next anniversary of Lenin’s birthday. Andropov, who was a member of the Politburo but did not hold any posts in the Central Committee, was instructed to deliver the speech. For many, this fact became evidence of the choice made by Brezhnev.

By that time, Andropov had strengthened his apparatus positions on the wave of the fight against corruption.He began an investigation into abuses in the Krasnodar Territory, where the first secretary of the regional committee, a member of the Central Committee, Sergei Medunov, became famous for his lordly manners. The time has come to check the dirt on Sharaf Rashidov that has accumulated in recent years. According to rumors, Leonid Ilyich himself initiated the “Uzbek case”, whispering to the guards after the incident in Tashkent that it was Rashidov who wanted to kill him.

Chernenko’s entourage began spreading rumors about Andropov’s incurable illness. Evgeny Chazov recalled how one day Brezhnev called him and suddenly asked: “Evgeny, why don’t you tell me anything about Andropov’s health? How is he? I was told that he was seriously ill and his days were numbered.”

Strengthened the position of Andropov and support from Defense Minister Dmitry Ustinov and authoritative Foreign Minister Andrei Gromyko.In May 1982, Andropov was elected secretary of the Central Committee of the CPSU and he began to conduct meetings of the secretariat of the Central Committee, removing Chernenko from the chair.

However, the results of the struggle for power were not yet predetermined. Chernenko’s entourage began spreading rumors about Andropov’s incurable illness, which would not allow him to take control of the party and the country.

Chazov recalled Brezhnev’s sudden call, who asked: “Evgeny, why don’t you tell me anything about Andropov’s health? How is he doing? I was told that he was seriously ill and his days were numbered.”

And almost immediately afterwards, the alarm rang out from the alarmed Andropov: “I met with Brezhnev, and he asked me for a long time about my health, about my illness, about how he could help me. … Apparently, someone is playing on mine. illness. I ask you to reassure Brezhnev and dispel his doubts and suspicions about my future. ”

Last parade

All this happened against the background of Brezhnev’s rapidly dying health. Vladimir Medvedev, who was on duty at the secretary general in the hospital, recalled how his comrades-in-arms persuaded Brezhnev, who had not yet retired from the incident in Tashkent, to appear at the May Plenum of the Central Committee:

“Brezhnev turned to the others:

– You see my condition.It’s hard – two hours on the podium.

Everyone spoke with one voice:

– Find the strength in yourself. This is necessary for the world community. It is necessary for you to rise to the podium. “

Special project on the topic

At the end of the Plenum, the head of the country was again sent to the hospital. In the months remaining before his death, Brezhnev occasionally appeared in public, but it would be better if he did not. So, his visit to Baku ended with another embarrassment.

“I’m going to the dacha in the car.”Mayak” means 11 o’clock, – Anatoly Chernyaev recalled. – I ask the driver to turn up the volume – a live broadcast from Baku. Aliyev opens and gives the floor (Leonid Brezhnev. – Approx. TASS ). Inarticulateness begins, indicating that our leader is in a deplorable phase of his flickering consciousness. Apparently, he himself does not understand and does not hear what he is saying, and all the energy is spent on reading each next word (which is not always possible). After each phrase – applause, thunderous applause.Ten minutes pass. Instead of “Azerbaijan” he says “Afghanistan” and suddenly he completely stops talking … “

On November 7, Brezhnev stood for two hours at the Mausoleum, watching the parade in honor of the anniversary of the October Revolution. And three days later he died in his sleep at the dacha in Zavidovo. The apparatus struggle for power was won, as many expected, by Andropov.

Alexander Kobelyatsky

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