The reliability of the Neer classification for proximal humerus fractures: a survey of orthopedic shoulder surgeons

• DOI: 10.1016/j.jseint.2022.02.006
• Publication Date: 2022-02-26T16:43:02Z
• Authors: Mikaël Chelli; Gregory Gasbarro; Vincent Lavoué; Marc-Olivier Gauci; Jean-Luc Raynier; Christophe Trojani; Pascal Boileau
• Keywords: Gold standard (test)

The Neer classification is among the most widely used systems to describe proximal humerus fractures (PHF) despite poor interobserver agreement. purpose of this study was verify whether or not blinded shoulder surgeons and trainees agree with authors articles published in highest impact-factor orthopedic journals.All regarding PHF between 2017 2019 top 10 journals as rated by impact factor were searched. Articles included if at least 1 figures. Figures extracted without legend, X-rays ± computed tomography scan images when available. An international survey conducted 138 who asked record for each de-identified radiograph publications. type fracture mentioned legend figure considered gold standard.Survey participants agreed article 55% cases overall (range 6%-96%, n = 35). common response disagreed 13 (37%), underestimating number parts 11 cases. agreement responders fair (k 0.296). There an association percentage concordant answers greater experience (number years surgery practice) (P .0023). parts, available imaging modalities, geographic origin did influence authors.In more than one-third cases, specialized disagree interpreting manuscripts. Morphologic sole basis treatment algorithms surgical success should be scrutinized.