Neer developed a classification for fractures of the proximal humerus. This can be used to describe a specific fracture pattern for comparison of outcomes. The author was from Columbia University in New York City.
Parameters:
(1) displacement and number of fragments
(2) location and dislocations
Number of types: 16
Appearance
Type
minimally displaced fragments ( 2 or more pieces)
1
articular surface of humeral head split down the middle by the scapula
15
scapula impacted into articular surface of humeral head
16
Location
2 Parts
3 Parts
4 or more Parts
anatomic neck
Type 2
(? 15)
surgical neck
Type 3
greater trochanter
Type 4
Type 8
Type 12
lesser trochanter
Type 5
Type 9
Type 12
anterior dislocation
Type 6
Type 10
Type 13
posterior dislocation
Type 7
Type 11
Type 14
Limitations:
• In the study of Sidor et al, 5 observers agreed on 32% of fractures on the first viewing. The mean reliability was 0.48 for the first viewing and 0.52 for a second viewing.
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