Neer classification of distal clavicle fractures

Seb Belfrage and Andrew Murphy et al.

The Neer classification of distal clavicular fractures along with the AO classification system is one of the more frequently used classification systems when assessing distal clavicular fractures. The classification system, broken into five categories communicates both the stability and treatment recommendation of the fracture focusing on the relationship of the fracture to coracoclavicular ligaments and the acromioclavicular joint.

Type I

Considered a stable fracture requiring nonoperative treatment

  • minimally displaced fracture line sits lateral to the coracoclavicular ligaments
  • trapezoid and/or conoid ligament intact
Type IIA

Considered an unstable fracture requiring operative treatment

  • fracture is medial to the coracoclavicular ligament with significant displacement of the medial portion
  • conoid ligament intact
  •  trapezoid ligament intact
Type IIB

Considered an unstable fracture requiring operative treatment

  • the fracture occurs between coracoclavicular ligament resulting in the conoid ligament torn and the trapezoid ligament intact. Or the fracture is lateral to coracoclavicular ligament leaving both the conoid and trapezoid ligament torn
  • displacement of the medial clavicle 
Type III

Considered a stable fracture requiring nonoperative treatment

  • intra-articular distal clavicular fracture extending into the acromioclavicular joint
  • conoid ligament intact
  • trapezoid ligament intact
Type IV

Physeal fracture considered stable fracture requiring nonoperative treatment

  • medial portion clavicle becomes displaced in the superior direction as the periosteal sleeve becomes avulsed from the inferior cortex
  • conoid ligament intact
  • trapezoid ligament intact
Type V

Considered an unstable stable fracture requiring operative treatment

  • comminuted fracture with medical clavicle displacement
  • conoid ligament intact
  • trapezoid ligament intact

Fractures

Article information

rID: 74187
Synonyms or Alternate Spellings:
  • Distal clavicular fractures (Neer classification)
  • Distal clavicle fractures (Neer classification)
  • Neer classification of distal clavicular fractures

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