Humerus Fractures, Proximal

• Proximal fractures of the humerus only account for about 5% of all fractures but account for 45% of all humeral fractures.
• We should be familar with the Neer Classication System for Humeral fractures, which can also be seen at http://health-7.com/Handbook%20of%20Fractures/15%20-%20Proximal%20Humerus%20Fractures
   
• The classification system classifies fractures based on
  • 1-part
  • 2-part
  • 3-part
  • 4-part
• The bony segments that make up the parts are
  • Greater Tuberosity (GT)
  • Lesser Tuberosity (LT)
  • Humeral Head
  • Humeral Surgical Neck (SN)
• A part is defined as displaced if >1 cm of fracture displacement or >45 degrees of angulation.
• The greater the number of parts the more likely the patient will require surgery or have increased complications.
  • 3 and 4 part fractures are often fixed surgical due to the increased risk of vascualr compromise to the humeral head.