[Neer classification of the proximal humerus fractures based on our own material]

About 4-5% of all fractures are localised to the proximal end of the humerus. During the last 30 years a two-time increase has been observed. The cause was ageing of population and a higher incidence of fractures. Treatment improved owing to proper classification based on radiological diagnostics.

The principles of diagnostic and classification were presented on the basis of the literature and analysis of the clinical material.

We analysed the ways of the diagnosis and classification of the proximal humerus fractures in 166 patients treated in Traumatologic and Orthopaedics Department of the Bielański Hospital in Warsaw and in Orthopaedics Department of the Medical Postgraduate Medical Education Centre in Otwock during years 1988-2004.

The classification suggested in 1970 by Neer has firmly established the way of treatment, is easy to remember, and regarded as the most popular and acceptable practice. It is based on dislocation one or more of the four bone fragments: shaft, head with articular surface, greater and lesser tuberosity of the humerus. Proper assessment of the type of fracture requires precise identification of these elements on radiograms. Correct assessment of dislocations of bone fragments and the way of dislocations is essential matter because specificity of the blood supply that improves heeling of the fracture and efficiency of the affected limb in the future.

It was found that conventional plain radiograms made in AP and Y exposures were sufficient for recognition the type of fracture. When diagnosis was questionable examination had to be broadened by axillar exposure and CT performed in the stated sequence.