Comparison study between valgus and varus type in Neer 's 3 and 4 part proximal humerus fracture

Abstract

Purpose : We reclassified three- and four-part proximal humerus fractures by Neer ’ s classification into valgus & varus type, and compared the results of these groups. Materials & methods : 21 cases classified as three- and four-part fracture in Neer ’ s classification were treated surgically and followed for 12 months. We reclassfied the 21cases valgus and varus type fractures, according to angulation of fractures, facing of humeral head, and dominant displaced tuberosity. Functional evaluation was done by UCLA shoulder rating scale. R e s u l t s : Neer ’ s three- and four-part proximal humerus fractures could be reclassified based on angulation, facing of humeral head, and dominant tuberosity displacement. The functional results according to UCLA shoulder rating scale were good or excellant in 8 of 9 cases of valgus type(89%), and at 4 in 10 cases of varus type(40%). The clinical result of the valgus type was better than that of the varus type. C o n c l u s i o n : Based on reclassification system of proximal humerus fractures, clinical results and radiographic findings including angulation, facing of head, and dominant tuberosity displacement showed close relationship. Neurovascular complication were more frequent in the varus type. Therefore, careful evaluation including surgical approach and soft tissue status should be considered in the varus type of complex proximal humerus fracture.