Neer Classification (Proximal Humerus Fractures)
Neer (1970, revised 2002)Classifies proximal humerus fractures by counting how many of the four anatomic segments - articular head, greater tuberosity, lesser tuberosity, and shaft - are displaced. A segment counts as displaced when it is separated by more than 1 cm or angulated more than 45 degrees.
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Information
Incomplete input
- Answer for each of the four segments whether it is displaced (separation greater than 1 cm or angulation greater than 45 degrees).
How this tool works
Neer's 1970 four-segment classification evaluates the proximal humerus as four potential parts. A fracture with no segment displaced beyond the thresholds is a one-part fracture regardless of how many fracture lines exist; displacement of one, two, or three or more segments defines two-part, three-part, and four-part fractures. Classic three-part patterns combine a displaced surgical neck with one displaced tuberosity, and the remaining attached tuberosity produces a rotational deformity of the head. Four-part fractures carry the highest risk of avascular necrosis because the articular segment loses its soft-tissue attachments; a lower-risk valgus-impacted four-part variant was added in 2002. Fracture-dislocations and head-splitting or impression fractures form separate categories within Neer's broader six-group scheme.
References
- StatPearls: Proximal Humerus Fracture.
- Carofino BC, Leopold SS. Classifications in Brief: The Neer Classification for Proximal Humerus Fractures. Clin Orthop Relat Res 2013;471:39-43.
Implemented from the cited published sources. Educational use only; confirm against current guidelines before clinical use.
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