Neer's Classification

1. Background and Importance

  • Charles S. Neer II (1970) proposed this classification system to standardize the description and management of proximal humerus fractures.
  • It remains one of the most widely used systems in orthopaedic trauma practice


Neers System is based on:

  • Anatomical segments (parts) of the proximal humerus.
  • The degree of displacement between them.
  • It provides guidance for management and prognosis.

2. Anatomy Basis — The Four Anatomical Segments

  • According to Neer, the proximal humerus consists of four potential segments (“parts”) that may fracture or displace independently:

  • Articular segment (Head)
  • The humeral head above the anatomical neck.
  • Risk of avascular necrosis (AVN) if blood supply is disrupted.


  • Greater tuberosity
  • Lateral projection where supraspinatus, infraspinatus, and teres minor attach.
  • Displacement affects rotator cuff function.


  • Lesser tuberosity
  • Medial projection where subscapularis attaches.
  • Displacement causes internal rotation weakness.


  • Humeral shaft (diaphysis)
  • Extends distally below the surgical neck.
  • Common site for angulation and malunion.

3. Concept of a “Part” in Neer’s System

  • A fragment is considered a separate part only if it is displaced by more than:

    • 1 cm (10 mm), or

    • Angulated by more than 45°.

👉 If the displacement or angulation is less than these limits, the fragment is not considered a separate part — the fracture is treated as minimally displaced.

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