Codman showed that fractures of the proximal humerus occurred along the former lines of the epiphyseal and there were 14 types of fracture. Neer classified 7 types of fractures into a 2-part, 3-part and 4-part fracture(group 1) and this classification had a correlation with vasculality of the humerus head and selection of treatment procedures. However, there are few reports about the other 7 types of fracture(group 2) and there was no classification of the fractures. We studied 603 fractures of the proximal humerus in 603 cases by evaluating X-ray films. 266 were males and 337 were females. The average age was 52.6 years old(range: 18∼99). We classified these fractures by Codman classification. 19 fractures (3.1%) came under group 2. They were (1)(HH:humerus head)+(GT:greater tuberosity • LT:lesser tuberosity)+(shaft) 6 fractures, (2)(HH )+(GT • shaft)+(LT) 1 fracture, (3)(HH)+(LT • shaft)+(GT) 7 fractures, (4)(HH • shaft)+(GT)+(LT) 3 fractures, (5)(HH • shaft)+(GT • LT) 1 fracture, (7)(HH • LT)+(GT • shaft) 1 fracture.8 of these fractures came under Neer's minimally displaced type, 3 fractures Neer's 2-part fracture and 8 fractures(1.3%) were not described in Neer classification.
Fractures that were not described in Neer classification were rare(1.3%). We could manage these fractures respecting Neer's concept of assessing the circulation of the head and degrees of displacement and current knowledge of the humerus head circulation. So we conclude that Neer's classification was practical.
