Fracture Severity Based on Neer Classification Does Not Predict Short-term Complications Following Reverse Shoulder Arthroplasty


Proximal humerus fractures (PHF) are common in elderly and osteoporotic patients, and these fractures are often described using the Neer classification. As reverse shoulder arthroplasty (RSA) for PHF becomes more common, it is helpful to identify the utility of Neer classification in predicting postoperative outcomes for patients undergoing RSA. The medical records of patients undergoing primary RSA for PHF at a single academic institution from 2013–2019 were identified using medical billing codes. A multivariable logistic regression analysis identified independent factors associated with all cause 90-day readmissions, reoperation, and length of stay (LOS) greater than three days. Fifty-five patients (average age of 72.3 ± 8.6 years) were included. No statistically significant differences among two-, three-, and four-part fractures with regard to LOS, discharge location, 90- day readmission, revision surgery, postoperative dislocation, or deep infection were detected. These findings suggest that Neer classification for PHF is not predictive of short-term complications after RSA. (Journal of Surgical Orthopaedic Advances 31(2):104–108, 2022)

Key words: Neer Classification, reverse shoulder arthroplasty, proximal humerus fracture, postoperative outcomes

Barrie S. Sugarman, MD1; Jeffrey A. O’Donnell, MD; Elshaday S. Belay, MD; Daniel Goltz, MD, MBA; Richard Danilkowicz, MD; Mark Gage, MD; Christopher S. Klifto, MD; and Oke A. Anakwenze, MD