Evaluation of the Neer System of Classification of Proximal Humeral Fractures with Computerized Tomographic Scans and Plain Radiographs*

Poor reproducibility of classification of proximal humeral fractures: Additional CT of minor value

“…Like Bernstein et al (1996), we found that CT, together with plain radiographs, did not make fracture classification more consistent. There was a moderate agreement between the observers when using the Neer classification, but only a fair agreement with the A 0 classification.…”

“…However, the use of CT in our study did not improve the classification, when compared with previous studies using plain radiographs (Siebenrock andGerber 1993, Sidor et al 1993). Bernstein et al (1996) found that CT, added to plain radiographs, increased intraobserver reliability slightly, but did not improve interobserver reproducibility.…”

CORR Insights®: Is Arthroscopic Technique Superior to Open Reduction Internal Fixation in the Treatment of Isolated Displaced Greater Tuberosity Fractures?

“…Improvements in our understanding and management of displaced greater tuberosity fractures will depend on improved interobserver reliability in the classification of fractures. CT scan, especially with three-dimensional reconstruction, may be a valuable tool in improving our ability to classify fractures adequately and improve the validity of comparison series such as this [1]. We can improve upon arthroscopic techniques so that fractures with even larger fragments, and with greater displacements, can be adequately managed arthroscopically.…”

Proximal humeral fractures

“…16,25 On the other hand, new progress in PHF studies, especially in vascularization, allows the definition of important new characteristics for treatment decision-making. [26][27][28][29][30] Because important new concepts for prognosis and treatment of PHF do not easily fit in past classification systems, some authors have proposed new imaging techniques 8,12 or new functional classifications. 14 Since 2003, new systems of fracture classifications have been published.…”