Neer's Part II study compares closed reduction, open reduction, and prosthetic replacement in 117 consecutive three-part and four-part displaced proximal humeral fractures followed 1–16 years, asking which treatment strategy produces the best outcomes for each fracture pattern.
While modern techniques have evolved, Neer's core principle remains relevant: fracture pattern complexity should guide treatment selection.
The recognition that four-part fractures carry high avascular necrosis risk continues to influence contemporary decisions between ORIF and arthroplasty, though newer implants and techniques have expanded salvage options.
Neer's Part II study compares closed reduction, open reduction, and prosthetic replacement in 117 consecutive three-part and four-part displaced proximal humeral fractures followed 1–16 years, asking which treatment strategy produces the best outcomes for each fracture pattern.
While modern techniques have evolved, Neer's core principle remains relevant: fracture pattern complexity should guide treatment selection.
The recognition that four-part fractures carry high avascular necrosis risk continues to influence contemporary decisions between ORIF and arthroplasty, though newer implants and techniques have expanded salvage options.