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-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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Elective Implant Removal In Symptomatic Patients After Internal Fixation Of Proximal Humerus Fractures Improves Clinical Outcome Topic Of Research Paper In Clinical Medicine Download Scholarly Article Pdf And Read For Free
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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