The epidemiology of proximal humeral fractures

We present a 5-year prospective study of the epidemiology of 1,027 proximal humeral fractures. These fractures, which tend to occur in fit elderly per sons, have a unipolar age distribution and the highest age-specific inciden ce occurs in women between 80 and 89 years of age. The commonest was the B1 .1 impacted valgus fracture, found in one-fifth of the cases in this series , a type that is not included in the Neer classification. We used both Neer and AO classifications. The AO classification proved to b e more comprehensive because in the Neer classification, half of the fractu res are minimally displaced and almost nine-tenths fall into only three cat egories. In the AO classification, the B1.1, A2.2, A3.2 and A1.2 sub-groups comprise over half of all proximal humeral fractures, while the AO type C fractures occur in only 6%. We suggest that the literature does not adequat ely reflect the spectrum of proximal humeral fractures.