Classic history and presentation: A classic history is an older patient with osteoporosis who fell from standing height onto an outstretched hand.
Prevalence:
- Age – Usually seen in patients older than 50 years.
- Sex / gender – Twice as common in female patients.
Pathophysiology: GT fractures are caused by traumatic injury to the arm or shoulder joint. The fragment generally gets pulled superiorly by the supraspinatus and/or infraspinatus.
Grade / classification system: Neer classification for proximal humerus fractures.
In order to be classified as a fractured part, the fractured component needs to either be displaced greater than 1 cm or have angulation exceeding 45 degrees. The exception is the greater tuberosity, which is considered displaced at 5 mm.
- One-Part Fracture
- Fracture involves 1-4 parts.
- No parts are displaced.
- Two-Part Fracture
- Fracture involves 2-4 parts.
- One part is displaced.
- Three-Part Fracture
- Fracture involves 3-4 parts.
- Two parts are displaced.
- Four-Part Fracture
- Fracture involves more than 4 parts.
- Three parts are displaced.