A 28-year-old cricketer falls on an outstretched hand and sustains a proximal humerus fracture. X-ray shows displacement of both the greater tuberosity (>5 mm) and the surgical neck with 45° angulation, but the articular segment retains blood supply. According to the Neer classification, this is a:

• A Three-part fracture ✓
• B Two-part fracture
• C Four-part fracture
• D One-part fracture (minimal displacement)

Explanation

Neer classification counts the number of displaced parts among four segments: articular segment, greater tuberosity, lesser tuberosity, and shaft. A part is displaced if there is >1 cm translation or >45° angulation. In this case, both the greater tuberosity and the surgical neck (shaft-articular segment unit) are displaced — that constitutes two displaced parts, making it a three-part fracture (with the articular segment and shaft counted together). Four-part fractures displace the articular segment from both tuberosities and the shaft, risking avascular necrosis.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.