ArticleJSES international2022
The reliability of the Neer classification for proximal humerus fractures: a survey of orthopedic shoulder surgeons.
Article in JSES international, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 14 citations in OpenAlex.
- Management of proximal humerus fractures: a review of contemporary treatment options.JSES reviews, reports, and techniques · 2026Review
- The limited value of routine radiographs in the follow-up treatment of proximal humerus fractures.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Total elbow arthroplasty-a historical review.JSES reviews, reports, and techniques · 2026Review
- Prognostic value of the Neer and Mayo-Fundacion Jimenez Diaz classifications in reverse shoulder arthroplasty for proximal humerus fractures.JSES reviews, reports, and techniques · 2026Article
- Article
- Can Hertel Criteria Reliably Predict Avascular Necrosis After Intracapsular Proximal Humerus Fractures in the Elderly? A Retrospective Analysis.Journal of personalized medicine · 2026Article
- Proximal Humerus Fractures - A Contemporary Narrative Review of Management Strategies.Orthopedic reviews · 2026Article
- Review
- Delphi method consensus on radiographic characteristics influencing management decisions for proximal humerus fracture.Journal of orthopaedic surgery and research · 2025Article
- Randomized controlled trials investigating proximal humerus fractures lack consensus in inclusion criteria.JSES reviews, reports, and techniques · 2025Article
- Post-reduction reclassification dilemma in proximal humeral fracture-dislocation: A case report and practical considerations.International journal of surgery case reports · 2025Article
- Clinico-radiological outcomes of four-part proximal humerus fracture fixation with fibular strut graft augmentation.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Proximal humerus fracture and acromioclavicular joint dislocation.Innovative surgical sciences · 2024Review
- Computed Tomography Does Not Improve Intra- and Interobserver Agreement of Hertel Radiographic Prognostic Criteria.Medicina (Kaunas, Lithuania) · 2022Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The Neer classification is among the most widely used systems to describe proximal humerus fractures (PHF) despite the poor interobserver agreement. The purpose of this study was to verify whether or not blinded shoulder surgeons and trainees agree with the authors of articles published in the highest impact-factor orthopedic journals. Methods: All articles regarding PHF published between 2017 and 2019 in the top 10 orthopedic journals as rated by impact factor were searched. Articles were included if the authors used the Neer classification to describe at least 1 PHF in the figures. Figures were extracted without the legend, and X-rays ± computed tomography scan images were included when available. An international survey was conducted among 138 shoulder surgeons who were asked to record the Neer classification for each de-identified radiograph in the publications. The type of fracture mentioned in the legend of the published figure was considered as the gold standard. Results: Survey participants agreed with the published article authors in 55% of cases overall (range 6%-96%, n = 35). The most common response disagreed with the article authors in 13 cases (37%), underestimating the number of parts in 11 of 13 cases. The interobserver agreement between the 138 responders was fair (k = 0.296). There was an association between the percentage of concordant answers and greater experience (number of years of shoulder surgery practice) of the responders ( Discussion: In more than one-third of cases, specialized shoulder surgeons disagree with article authors when interpreting the Neer classification of de-identified images of PHF in published manuscripts. Morphologic classification of PHF as the sole basis for treatment algorithms and surgical success should be scrutinized.
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