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.
Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general