title: [Fractures of the humeral head. Conservative and surgical differential therapy].
abstract: The Neer classification for fractures of the proximal humerus is a system based on accurate identification of the four major fragments and their relationship to each other. There is a specific type of displaced 4-fragment fracture of the proximal humerus which consists in valgus impaction of the head fragment. This type of fracture is combined with a lower rate of avascular necrosis than that of other displaced 4-fragment fractures. In addition, the outcome is different according to whether a displaced 4-fragment fracture affects the surgical or the anatomical neck. Those through the surgical neck have a much lower rate of avascular necrosis than those through the anatomical neck. Therefore, 4-fragment valgus impacted fractures through the surgical neck should be treated by open reduction and internal fixation rather than by primary hemiarthroplasty in younger patients.
authors.affiliation: Chirurgische Klinik und Poliklinik, Klinikum Innenstadt der Ludwig-Maximilians-Universität München.
authors.forename: P
authors.initials: P
authors.lastname: Habermeyer
authors.forename: L
authors.initials: L
authors.lastname: Schweiberer
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D001863:Bone Screws; D001864:Bone Wires; D002370:Casts, Surgical; D002648:Child; D005592:Fracture Fixation / Q000379:methods*; D006801:Humans; D007595:Joint Prosthesis; D011859:Radiography; D012784:Shoulder Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*
vernacular_title: Oberarmkopffrakturen. Konservative und operative Differentialtherapie.