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Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Neer classification

Introduction

Proximal humerus fracture
Overview[1][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 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

See also


Template:Fractures

Template:WikiDoc Sources

References

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.

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