AO Surgery Reference is an internetbased resource for the management of fractures, based on current clinical principles, practices and available evidence It describes the complete surgical management process from diagnosis to aftercare for fractures in a given anatomical region, and also assembles relevant published AO materialThe partial articular type does not exist in the humerus or femurProximal humeral fractures have been classified since the earliest known medical texts From 1970 the most commonly used classification system for proximal humeral fractures has been the Neer classification followed by the AO classification Both classification systems describe morphological aspects of the fracture anatomy in an ordinal
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Ao classification proximal humerus fracture
Ao classification proximal humerus fracture-The aim of the present study was to evaluate functional outcome and complication rate after open reduction and internal fixation of displaced proximal humerus fractures by proximal humerus AOKeywords Proximal humeral fractures, Proximal humerus fractures, Shoulder fractures, Fracture classification, Neer, AO, OTA Background Within the last decades there has been a quest for randomised trials, wellconducted observational studies, and systematic reviews of interventions for fractures of the proximal humerus
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Charles Neer's classification of the proximal humeral fractures in 1970 is the most widely used system for classifying these fractures The essence of this method of classification is based on the anatomical concepts described by Codman in the 1930s The proximal humerus subdivided into four segments 1) the humeral head superior to the anatomical neck 2) greater tuberosity 3) lesser tuberosity 4) humeral shaftProximal Humerus Fracture Classifications A1 Gr tuberosity avulsion Lesser tuberosity avulsionMalleolar fractures are coded as distal tibia/fibula fractures 1 Humerus 2 Radius/Ulna 3 Femur 4 Tibia/Fibula 1 Humerus 2 Radius/Ulna 1 = Proximal 2 = Shaft 3 = Distal E = Epiphysis M = Metaphysis D = Diaphysis M = Metaphysis E = Epiphysis 3 Femur 4 Tibia/Fibula The three segments can be defined as
The proximal end segment of the humerus and femur are exceptions Simple proximal humeral fractures involving one tuberosity or the metaphysis (unifocal or Neer 2part fractures) and proximal femoral fractures involving the trochanteric area are type A;The Neer system divides the proximal humerus into 4 parts and considers not the fracture line, but the displacement as being significant in terms of classification The four parts are humeral head;The classification of proximal humeral fractures remains challenging The two main classification systems used, the Neer and the AO classification, have both been shown to have less than ideal interobserver agreement Agreement in classification is required, however, to guide fracture management
BACKGROUND The classification of proximal humeral fractures remains challenging The two main classification systems used, the Neer and the AO classification, have both been shown to have less than ideal interobserver agreement Agreement in classification is required, however, to guide fracture managementThe principles of fracture classification • Generally, proximal and distal segments are defined by a square whose sides = length of widest part of epiphysis • Exceptions Proximal femur Proximal humerus Malleolar segment 12There are 2 main classifications used for PHF (Neer and AO classifications) and one specific to GT fractures In 1970, Neer proposed a classification, which divides the proximal humerus in 4 functional parts the head (articular segment), lesser tuberosity, GT, and humeral shaft
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Outcome validation of the AO/OTA classification system Conclusions Ctype fractures had a significantly worse functional performance and impairment compared with Btype fractures, but Btype fractures were not statistically different from Atype fractures MF Swiontkowski et al 00 AO Classification 0 05 1 15 2 25 3 35 4 45 ImpairmentAO/OTA Classification Based on fracture location and the presence of impaction, angulation, translation, comminution, or dislocation Each fracture type is further subgrouped according to displacement, valgus or varus angulation of the humeral head, comminution and the presence and direction of glenohumeral joint dislocationThe fractures were classified according to the Neer and the AO/OTAclassification by two experienced trauma surgeons with a special interest in proximal humeral fractures in a consensus conference Based on plain radiographs and CTscans Kettler et al 26 classified 225 displaced 2, 3 and 4part fractures (mean age 66) in patients treated with locking plates
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Proximal Humerus AO Classfication – www2aofoundationorg AO/OTA Classification Based on fracture location and the presence of impaction, angulation, translation, comminution, or dislocationDespite recent modifications, the AO classification system for proximal humerus fractures plays a rather scientific role and—in contrast to other fracture sites—has not found its way into clinical use due to its complexity with a total of 27 subtypes 14, 15The AO classification proved to be more comprehensive because in the Neer classification, half of the fractures are minimally displaced and almost ninetenths fall into only three categories In the AO classification, the B11, 2, A32 and A12 subgroups comprise over half of all proximal humeral fractures, while the AO type C fractures
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Overall, the OTA/AO classification system for proximal humeral fractures has nine groups (11A1/2/3, 11B1/2/3, 11C1/2/3) All groups are divided into three subgroups based on the degree of displacement, impaction, or dislocation, resulting in a total of 27 subgroupsMaurice E Muller and the AO foundation came up with the widely accepted AO/OTA universal classifications (also called Muller AO Classification) 1) Every major bone and each bone segment areDisplacement Displacement is on a perpart basis
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The principles of fracture classification • Generally, proximal and distal segments are defined by a square whose sides = length of widest part of epiphysis • Exceptions Proximal femur Proximal humerus Malleolar segment 12The fractures were classified according to the Neer and the AO/OTAclassification by two experienced trauma surgeons with a special interest in proximal humeral fractures in a consensus conference Based on plain radiographs and CTscans Kettler et al 26 classified 225 displaced 2, 3 and 4part fractures (mean age 66) in patients treated with locking platesOlecranon fracture is a fracture of the bony portion of the elbowThe injury is fairly common and often occurs following a fall or direct trauma to the elbow The olecranon is the proximal extremity of the ulna which is articulated with the humerus bone and constitutes a part of the elbow articulation Its location makes it vulnerable to direct trauma
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We help you diagnose your Proximal humerus case and provide detailed descriptions of how to manage this and hundreds of other pathologiesProximal humeral anatomy includes four potential "parts" These parts were originally described by Neer and have been incorporated into his traditional classification scheme for PHFs Proximal humerus anatomy includes anatomic neck represents the old epiphyseal plate;The purpose of this study was to determine which classification of proximal humerus fractures leads to postoperative avascular necrosis of the humeral head The 3part and headsplit fracture in Neer classification, C22, C32, C33 in AO classification, and Type1B, Type3, Type4 in Yamane classification had high rate of postoperative avascular necrosis of the humeral head
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Pearl Proximal humerus fractures are classified based on the AO/OTA or Neer Classifications The AO/OTA classification places emphasis on the blood supply to the articular surface 1 If the greater/lesser tuberosity is still attached to the articular surface, there is a decreased risk for avascular necrosisProximal third humeral shaft fractures—A fracture entity not fully characterized by conventional AO classification Author links open overlay panel HWStedtfeld RBiber https//doiorg//jinjury Get rights and contentAO CLASSIFICATION 1 – HUMERUS 2 DIAPHYSIS A – SPIRAL– 1PROXIMAL ZONE 2 MIDDLE ZONE 3 DISTAL ZONE B OBLIQUE C TRANSVERSE 25
The Radiographic Union Score For Humeral Fractures Rushu Predicts Humeral Shaft Nonunion The Bone Joint Journal
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A number of classification systems of the proximal humerus are described in the literature, with the Neer and Arbeitsgemeinschaft für Osteosynthesefragenbeing (AO) the most widely used A simpler modified Neer system using only six fracture types is described by Bernstein but is not in common use 7Chapter 62 AO/ASIF Fracture Classification Fig 621 AO/ASIF fracture classification Proximal Humerus Fig 622 AO/ASIF fracture classification proximal humerus Humeral Shaft Fig 623 AO/ASIF fIn 1934, Codman developed a classification that divided the proximal humerus into four parts on the basis of epiphyseal lines In 1970, Neer's classification expanded on the fourpart concept and
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The validated AO Pediatric Classification of Fractures developed by Slongo was also included in the compendium 4, 5 The two committees confirmed the original premise that the revision process needed to be undertaken every 10 years criticisms of the proximal humerus and proximal femur classification, and to simplify the coding processThe AO classification system for proximal humeral fractures is not commonly used It is divided into 3 categories based on the severity of injury and likelihood of avascular necrosis of the humeralThe 5 classifications (Codman, Neer, Jakob, AO and Tamai classification) were used In the Codman classification, we defined the type's number clockwise from upward left Dividing the proximal end of the humerus into four segments, there were 14 patterns of the fracture
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Olecranon fracture is a fracture of the bony portion of the elbowThe injury is fairly common and often occurs following a fall or direct trauma to the elbow The olecranon is the proximal extremity of the ulna which is articulated with the humerus bone and constitutes a part of the elbow articulation Its location makes it vulnerable to direct traumaThe Müller AO Classification of fractures is a system for classifying bone fractures initially published in 1987 by the AO Foundation as a method of categorizing injuries according to therognosis of the patient's anatomical and functional outcome "AO" is an initialism for the German "Arbeitsgemeinschaft für Osteosynthesefragen", the predecessor of the AO Foundation11E Proximal epiphyseal 1 Humerus 11E/11 11E/21 11E/31 11E/11 Simple separation/SalterHarris I AO Pediatric Comprehensive Classification of LongBone Fractures (PCCF) by the AO Pediatric Classification Group and AO Clinical Investigation and Documentation (07)
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AO classification of proximal humeral fractures type A extraarticular unifocal (either tuberosity / surgical neck of the humerus ) A1 extraarticular unifocal A1 extraarticular unifocal fracture extraarticular unifocal fracture with impacted metaphyseal fracture A3 extraarticularOlecranon fracture is a fracture of the bony portion of the elbowThe injury is fairly common and often occurs following a fall or direct trauma to the elbow The olecranon is the proximal extremity of the ulna which is articulated with the humerus bone and constitutes a part of the elbow articulation Its location makes it vulnerable to direct traumaMalleolar fractures are coded as distal tibia/fibula fractures 1 Humerus 2 Radius/Ulna 3 Femur 4 Tibia/Fibula 1 Humerus 2 Radius/Ulna 1 = Proximal 2 = Shaft 3 = Distal E = Epiphysis M = Metaphysis D = Diaphysis M = Metaphysis E = Epiphysis 3 Femur 4 Tibia/Fibula The three segments can be defined as
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From 1970 the most commonly used classification system for proximal humeral fractures has been the Neer classification 11 followed by the AO classification 16 Both classification systems describe morphological aspects of the fracture anatomy in an ordinal framework aiming to support diagnostics, treatment and prognosticsComputed tomography (CT) images can be a useful tool in evaluation and classification of proximal humerus fractures The detailed bony detail of images can be used to evaluate tuberosity displacement, humeral head splitting and impaction components, degree of comminution, and any involvement of the glenoid articular surface (Fig 18 )Background The classification of proximal humeral fractures remains challenging The two main classification systems used, the Neer and the AO classification, have both been shown to have less than ideal interobserver agreement Agreement in classification is required, however, to guide fracture management
Figure 6 From The Arteries Of The Humeral Head And Their Relevance In Fracture Treatment Semantic Scholar
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AO classification of proximal humerus fractures type A extraarticular unifocal (either tuberosity / surgical neck of the humerus) A1 extraarticular unifocal fracture extraarticular unifocal fracture with impacted metaphyseal fracture A3 extraarticular unifocal fracture with nonimpacted metaphyseal fracture type B extraarticular bifocal (both tuberosities / surgical neck of
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