Humerus Fracture: Classification

According to the ICD-10, humerus fracture can be classified as follows:

  • Fracture of the proximal (“leaning toward the body”) end of the humerus (S42.2)
    • Fractura tuberculi majoris (The head is flanked by two bony prominences (tuberculum majus = major and tuberculum minus = minor)).
    • Fractura colli anatomici (synonym: subcapital humerus fracture, i.e., the intra- or extra-articular breaking off of the humeral head)
    • Fractura pertubercularis (synonym: fractura transtubercularis).
    • Fractura colli chirurgici (synonym: collum fracture, as humeral epiphyseal solution).
  • Fracture of the shaft of the humerus (S42.3).
  • Fracture of the distal (“away from the body”) end of the humerus (S42.4)

Classification of humerus fracture according to Neer.

Type Type description
Neer 1 Non-displaced or minimally displaced fracture
Neer 2 2-fragment fracture in the area of the collum anatomicum
Neer 3 2-fragment fracture ad axim, -ad latus, – with zone of comminution in the region of the collum surgicum
Neer 4 2-fragment fracture, 3-fragment fracture, 4-fragment fracture in the region of the greater tuberosity
Neer 5 2-fragment fracture, 3-fragment fracture, 4-fragment fracture in the area of the tuberculum minus
Neer 6 Luxation fracture (a partial or complete luxation with a fracture ) with anterior or posterior head luxation, respectively

Classification of humeral fracture according to the Association for the Study of Osteosynthesis (AO classification).

Type Type description
A1 Extraarticular (“outside the joint capsule”) unifocal fracture, tubercular

  • 1. tuberculum majus not dislocated
  • 2. tuberculum majus dislocated
  • 3. with glenohumeral dislocation.
A2 Extraarticular unifocal fracture, metaphyseal (section of bone between diaphysis (bone shaft) and epiphysis/bone ends) impacted (jammed; wedged)

  • 1. without malalignment in the frontal plane.
  • 2. varus malalignment (exists when, in a bone or joints, the angle located to the center of the body (= medial) is smaller than the norm).
  • 3. valgus malalignment (exists when a bone or joints to the body center located (= medial) angle is greater than the norm).
A3 Extraarticular unifocal fracture, metaphyseal not impacted

  • 1. single with angulation
  • 2. Simple with lateral displacement
  • 3. multi-fragmentary
B1 Extraarticular bifocal fracture, metaphyseally impacted

  • 1. lateral + tuberculum majus
  • 2. medial + tuberculum majus
  • 3. posterior + tuberculum majus
B2 Extraarticular bifocal fracture, metaphyseal not impacted

  • 1. without rotation (rotation) of the epiphyseal fragment.
  • 2. with rotation of the epiphyseal fragment.
  • 3. metaphyseal multi-fragmentary + a tubercle.
B3 Extra-articular bifocal fracture, with glenohumeral luxtion.

  • 1st cervicometaphyseal vertical + greater tuberosity intact + anteromedial luxation.
  • 2. cervicometaphyseal vertical + tuberculum majus fractured + anteromedial luxation.
  • 3. tuberculum minus fractured + posterior dislocation.
C1 Articular fracture, slightly dislocated

  • 1st cephalotubercular impacted in valgus position.
  • 2. cephalotubercular impacted in varus position.
  • 3. collum anatomicum
C2 Articular fracture, clearly dislocated and impacted

  • 1st cephalotubercular in valgus position.
  • 2. cephalotubercular in varus position
  • 3. transcephalic and tubercular in varus position.
C3 Articular fracture, with luxation

  • 1. collum anatomicum
  • 2. collum anatomicum and both tubercles
  • 3. cephalotubercular fragmentation.