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Journal of Bone and Joint Surgery - British Volume, Vol 86-B, Issue 3, 413-425.
doi: 10.1302/0301-620X.86B3.14428  
Copyright © 2004 by British Editorial Society of Bone and Joint Surgery
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A three-dimensional classification for fractures of the proximal humerus

G. Edelson, MD, FAAO, Chief1; I. Kelly, MD, FRCS, Senior Consultant Orthopaedic Surgeon2; F. Vigder, MD, Chief3; and N. D. Reis, MD, MS, FRCS, Senior Consultant Orthopaedic Surgeon4

1 Department of Orthopaedics
2 Glasgow Royal Infirmary, Glasgow G4 0SF, UK.
3 Department of Radiology, Poriyya Government Hospital, Tiberias 15208, Israel.
4 Rambam Hospital Centre, Haifa 31096, Israel.

Correspondence should be sent to Dr G. Edelson.

Existing classifications of fractures of the head of the humerus are inadequate in terms of interobserver reliability and the predictability of the clinical outcome. From a combined study of 73 fracture specimens in museums and 84 CT-three-dimensional reconstructions in patients, we have devised a classification which appears to be more useful clinically. Common patterns of fracture and a plausible mechanism of injury were observed.

In 3-D most proximal humeral fractures can be organised into five basic types. These correspond in some degree to the Codman/Neer classification, but differ significantly in regard to the more complex patterns of fracture. We observed a logical progression from simple to complex fractures. An interobserver reliability study was carried out which indicated the improved usefulness of this new 3-D concept in providing a common language among clinicians for classifying these injuries. When surgery is indicated, the 3-D concept is also invaluable in guiding the restitution of anatomy through either open or percutaneous means.




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C. M. Robinson, L. A. K. Khan, and M. A. Akhtar
Treatment of anterior fracture-dislocations of the proximal humerus by open reduction and internal fixation
J Bone Joint Surg Br, April 1, 2006; 88-B(4): 502 - 508.
[Abstract] [Full Text] [PDF]


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