Neer classification

Proximal humerus fracture

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammadmain Rezazadehsaatlou[2].

Overview

The injuries of the ball-and-socket shoulder joint considered as the Proximal humerus fracture. It is more common among the elderly population following a low energy trauma such as falling. Meanwhile, A few people experience the axillary nerve damage such as reduced sensation around the middle deltoid and/or axillary artery involvement.

Neer classification of proximal humerus fracture

Neer classification of proximal humerus fractures consisted of :

• Number of fractured parts of the humerus bone:

1. humerus head
2. greater tuberosity
3. lesser tuberosity
4. humerus shaft

• Displacement fractured parts of the humerus bone:

1. Displacement is on a per-part basis. A fracture part is considered displaced if angulation exceeds 45 degrees, or if the fracture is displaced by more than 1cm

Neer classification of proximal humerus fractures
One-part fracture 70-80%	fractured line: 1-4 parts no part is displaced (i.e <1cm and <45 degrees)	treated conservatively in almost all cases
Two-part fracture 20%	fractured line: 2-4 parts one part is displaced (i.e >1cm or >45 degrees)	anatomical neck surgical neck: most common greater tuberosity Common in the cases with the anterior shoulder dislocation a lower threshold of displacement (> 5mm) has been proposed lesser tuberosity: rare
Three-part fracture 5%	fractured line: 3-4 parts two parts are displaced (i.e >1cm or >45 degrees)	the lesser tuberosity and articular surface are not digreater tuberosity and humerus shaft are displaced but respect to the lesser tuberosity and articular surface which remain together most common three part pattern the greater tuberosity and articular surface are not displaced but the lesser tuberosity and humerus shaft are displaced
Four-part fracture <1%	fractured line: 4< parts three parts are displaced (i.e., >1 cm or >45 degrees)	Patients has non-operative poor outcome the articular surface is no longer attached to any parts of the humerus it has a high incidence of osteonecrosis

See also

• AO classification of proximal humerus fracture
• Neer classification
• Proximal humerus fracture
• Distal humerus fracture
• Humeral_shaft_fracture
• Humerus fracture

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