![]() This is the treatment of choice for young, active patients with unreconstructable humeral head fractures. Despite the recent trend towards reverse shoulder arthroplasty (RSA) for proximal humerus fractures, hemiarthroplasty remains a viable and important option in treatment options to consider for patients. Although a majority of these fractures can be successfully treated non-operatively, hemiarthroplasty has long been a primary surgical alternative. The total incidence of these fractures has increased in recent years. Policy of Dealing with Allegations of Research MisconductĪbstract: Fractures of the proximal humerus comprise 4–5% of all fractures of the appendicular skeleton with a high percentage seen in elderly females.Policy of Screening for Plagiarism Process.Four-Segment Classification of Proximal Humeral Fractures: Purpose and Reliable Use. Shoulder Fractures: The Practical Guide to Management. Disorders of the Shoulder: Diagnosis and Management (2 Volume Set). Clinical Epidemiology of Orthopedic Trauma. Treatment of Three-Part and Four-Part Displacement. Diagnosing Displaced Four-Part Fractures of the Proximal Humerus: A Review of Observer Studies. Brorson S, Bagger J, Sylvest A, Hrobjartsson A. An Assessment of Interobserver Variation. The Neer Classification of Fractures of the Proximal Humerus. Kristiansen B, Andersen U, Olsen C, Varmarken J. ![]() The Neer Classification of Displaced Proximal Humeral Fractures: Spectrum of Findings on Plain Radiographs and CT Scans. Kilcoyne R, Shuman W, Matsen F, Morris M, Rockwood C. This type of four-part fracture is considered its own category and has a different prognosis than typical four-part fractures 9. These fractures require operative management. This pattern has a high incidence of osteonecrosis 7. This pattern has poor non-operative results, and as the articular surface is no longer attached to any parts of the humerus which are attached to soft tissues. These fractures are uncommon (<1% of proximal humeral fractures) 6. three parts are displaced (i.e. >1 cm or >45°) with respect to the 4 th.These fractures account for approximately 5% of proximal humeral fractures 6. lesser tuberosity and shaft are displaced with respect to the greater tuberosity and articular surface which remain together.greater tuberosity and shaft are displaced with respect to the lesser tuberosity and articular surface which remain together.Two three-part fracture patterns are encountered 7: These fractures account for approximately 20% of proximal humeral fractures 6. a lower threshold of displacement (>5 mm) has been proposed 8.frequently seen in the setting of anterior shoulder dislocation 8.1 cm or >45°)įour possible types of two-part fractures exist (one for each part): Neer added a fifth group 9 more recently. The classification consists of four major groupings, based on the number of displaced parts. The Neer classification has been variably adapted by multiple authors. A minimally displaced fracture, even one that includes multiple fracture lines, however, merely constitutes a type I, one-part fracture. The simplest displaced fracture which is possible, therefore, is a two-part fracture. A fracture part is considered displaced if angulation exceeds 45°, or if the fracture is displaced by more than 1 cm 1. The Neer system divides the proximal humerus into four parts and considers not the fracture line, but the displacement as being significant in terms of classification.ĭisplacement is on a per-part basis. The two main components of the classification are the number of fracture parts and the displacement 1,4-6. The terminology and factors which influence the classification are essential for the utility of radiology reports of proximal humeral fractures. The Neer classification of proximal humeral fractures is probably the most frequently used system along with the AO classification of proximal humeral fractures.
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