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Neer classification

Proximal humerus fracture

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

Overview[1][2]

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


Template:Fractures


Template:WikiDoc Sources

References

  1. ↑ Stone MA, Namdari S (April 2019). “Surgical Considerations in the Treatment of Osteoporotic Proximal Humerus Fractures”. Orthop. Clin. North Am. 50 (2): 223–231. doi:10.1016/j.ocl.2018.10.005. PMID 30850080.
  2. ↑ Lin KM, James EW, Spitzer E, Fabricant PD (February 2018). “Pediatric and adolescent anterior shoulder instability: clinical management of first-time dislocators”. Curr. Opin. Pediatr. 30 (1): 49–56. doi:10.1097/MOP.0000000000000566. PMID 29135565.

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