Proximal humerus fractures: Treatment controversies

The treatment of proximal humerus fractures is challenging, and significant controversy exists even regarding which patients are indicated for surgical treatment. When surgery is indicated, open reduction and internal fixation is the most common type of treatment. Arthroplasty is reserved for unreconstructible fractures. Hemiarthroplasty may not provide good, reliable function but may be the best option in younger or middle-aged patients when fracture fixation is not feasible. While several studies reported no benefit of surgical treatment in elderly patients, more recent literature showed better outcomes with reverse total shoulder arthroplasty.