Proximal Humerus Fractures Masterclass: Neer Classification & PROFHER Evidence

Master proximal humerus fractures by understanding the Neer classification system, critical humeral head blood supplyand the practice-changing PROFHER trial. Learn exactly when to operate and when to manage these common injuries non-operatively.

⏱ Chapters
0:00 Intro
0:19 Essentials
0:50 Neer Classification
1:26 Displacement Criteria
1:59 Blood Supply
2:32 Imaging Signs
3:10 Neer Parts Mnemonic
3:44 Management Algorithm
4:35 Surgical Technique
5:11 Key Numbers
5:49 Clinical reasoning — Manage
6:27 Clinical reasoning — Pearls

This comprehensive orthopaedic masterclass provides an in-depth review of proximal humerus fractures. We cover everything from the bimodal epidemiology and essential trauma series radiographs to the four-part Neer classification, vascular anatomy of the arcuate arteryand modern surgical decision-making involving locking plates and reverse shoulder arthroplasty.

🦴 IN THIS VIDEO YOU'LL LEARN
• How to apply the Neer classification by counting displaced anatomical parts using the 1cm or 45-degree rule
• The precise vascular anatomy of the proximal humerus and why the arcuate artery dictates avascular necrosis risk
• How the landmark PROFHER trial fundamentally changed the surgical management of displaced fractures
• The muscle forces that displace greater tuberosity, lesser tuberosityand shaft fragments
• Why valgus-impacted four-part fractures have preserved blood supply and remain amenable to fixation
• How to interpret the trauma series including the true AP Grashey, scapular Yand Velpeau axillary views
• The clinical indications for choosing non-operative care, ORIF with locking platesor arthroplasty
• Why greater tuberosity displacement of just 5mm threatens rotator cuff mechanics and warrants surgery
• How to assess the medial soft-tissue hinge on CT to determine humeral head viability

⏱️ CHAPTERS

📌 KEY TAKEAWAYS
✔️ Eighty-five percent of proximal humerus fractures are minimally displaced and highly successful with non-operative management in a sling.
✔️ A fragment only counts as a separate 'part' if it is translated more than 1cm or angulated beyond 45 degrees.
✔️ Avascular necrosis risk escalates from 3-14% in three-part fractures up to 15-35% in four-part patterns.
✔️ Valgus-impacted four-part fractures preserve the medial hinge and blood supply, making them fixable despite their complexity.
✔️ The PROFHER trial demonstrated no functional difference at two years between operative and non-operative treatment for many displaced fractures.
✔️ Elderly patients with severe displaced patterns or head-split injuries are best managed with reverse shoulder arthroplasty.

👩‍⚕️ WHO THIS IS FOR
This video is designed for orthopaedic trainees, junior doctorsand medical students seeking a comprehensive understanding of shoulder trauma. Curious patients looking for an in-depth, educational perspective on proximal humerus fracture management will also find it highly valuable.

📚 RELATED TOPICS: Shoulder dislocation and glenohumeral instability · Rotator cuff injuries and assessment · Humeral shaft fractures and radial nerve injury · Distal radius fractures in the elderly population · Reverse shoulder arthroplasty biomechanics and indications

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🎨 CREDITS
• Original Orthovellum production.

⚠️ DISCLAIMER: Educational only — not individual medical advice. Always consult a qualified clinician for diagnosis and treatment.

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Видео Proximal Humerus Fractures Masterclass: Neer Classification & PROFHER Evidence канала OrthoVellum