The three-dimensional anatomy of proximal humeral fractures.
OBJECTIVE
Three-dimensional (3D) computed tomography (CT) reconstructions have the potential to convey the anatomy of proximal humeral fractures more realistically than do standard 2D images.


METHODS
Proximal humeral fractures in 248 adult patients were examined prospectively using 3D CT reconstructions. To our knowledge, this represents the largest reported series of such fractures examined by this method.


RESULTS
Of 248 fractures examined by a 3D classification system, 14% were of the 2 Part type, 36% were 3 Part, 21% were Shield fractures, 13% were isolated tuberosity injuries, and 16% were fracture dislocations.


CONCLUSIONS
This study led to a modification of the Neer classification system. The frequency of each type of injury in this new classification is presented and a technique for viewing 3D images is suggested which maximizes their usefulness.


METHODS
Level 2; Clinical, observational, and prospective.
Edelson
Gordon
G
Orthopedic Department, Poriya Government Hospital, Tiberias, Israel. edelson@bezeqint.net
Saffuri
Husam
H
Obid
Elias
E
Vigder
Fina
F
D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012784:Shoulder Fractures / Q000145:classification* / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods