A 45-year-old falls on an outstretched hand and sustains a Neer Type II fracture-dislocation of the proximal humerus. Which combination of features defines this pattern?

• A 3-part fracture with rotator cuff tear
• B 2-part fracture with >1 cm displacement or >45° angulation ✓
• C Greater tuberosity avulsion with <1 cm displacement
• D Anatomic neck fracture with avascular necrosis

Explanation

In the Neer classification of proximal humerus fractures, a 'part' is defined as any segment that is displaced >1 cm or angulated >45°. A Neer Type II (2-part fracture) involves 2 displaced parts meeting these criteria — e.g., surgical neck with displaced shaft, or displaced greater tuberosity. Greater tuberosity avulsion with <1 cm displacement would be a 1-part (undisplaced) fracture. 3-part implies 3 displaced segments; anatomic neck fractures are a separate category with high AVN risk.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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