n Stage I: Local edema or hemorrhage; reversible condition. Usual age group: young, active individuals involved

in sports requiring excessive overhead use of arm.

n Stage II: Fibrosis, thickening of subacromial soft tissue,

rotator cuff tendinitis, and possible partial tear of rotator

cuff; manifested by recurrent pain. Usual age group: 25

to 40 years.

n Stage III: Complete rupture of rotator cuff, progressive

disability. Usual age group: over 40 years.

Fractures of the Proximal Humerus

Neer has classified fractures of the proximal humerus as to

the number of segments (18):

n One-part fractures of the proximal humerus are fractures

with minimal or no displacement or angulation.

n Two-part fractures consist of two major displaced fragments. This can include a displaced fracture of either the

greater or lesser tuberosity, fracture of the surgical neck,

or fracture of the anatomic neck.

n Three-part fractures consist of three major displaced

fragments. This can include fractures of both the greater

and lesser tuberosities, or a combination of fracture of

one of the tuberosities and fracture of the surgical neck.

n Four-part fractures consist of four displaced fragments,

such as those involving both tuberosities as well as the

surgical neck.

Anterior Dislocation of the Shoulder

In this injury, the humeral head dislocates anterior to the

glenoid; it accounts for 97% of shoulder dislocations. It

usually is diagnosed on anteroposterior radiographs. Definitive radiographic diagnosis is by the transscapular (“Y”

view) or axillary view.