Neer 分類にない骨折型の検討- Data base 668 例の分析 -

概要

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Neer classification is popular. However, there are some cases that can not be classified by it. We reviewed a detail of fracture types by using Codman classification, and clarified the fracture types that could not be classified and groped about for a better classification method. We classified 668 cases of Database by Neer and Codman classifications. In case of Neer classification, we defined a fracture as follows: a greater tubercle displaced beyond the top of the humeral head, a lesser tubercle clearly displaced from the humeral head or shaft, surgical neck displaced over 1/3 width of the shaft. On the other hand, the valgus impacted type of Jacob classification was added to this classification. There were 19 cases of valgus impacted type. And there were 23 cases that could not be classified by Neer classification in 668 cases. That number was smaller than our previous report. Those 23 cases looked like Types three, 6, 14, 15and 16 of Codman classification and humeral head fracture. Types 6 and 14 were less displaced and treated conservatively. Types 3, 15 and 16 had anatomical neck fractures and were mainly treated operatively. These 3 types seemed to need some review of the methods of treatment. We conclude that it is useful to change definitions of fractures and add a valgus impaction type, head fracture, 3, 15 and 16 types of Codman classification to the original Neer classification.
日本肩関節学会の論文