The Purpose: To compare clinical results of proximal humerus fractures following internal fixation with proximal humeral locked plate versus conservative treatment.

Materials and Methods: 25 patients sustained 3-part fractures of the proximal humerus. 8 were internally fixed and 17 were treated conservatively in two different centers.

Mean age: 65.4±12.7 Gender: 22 females, 3 males. Age and gender were similar in both groups. Follow up was longer in the conservative group (23.8 m ±7.5) compared to the operated one (11.1 m ±8.3).

All the patients were evaluated clinically using Constant’s score.

Statistical analysis was performed using Fisher’s exact test (examination rates differences), Mann-Whitney test (examination means difference) and Spearman’s test (evaluation of the correlation coefficient between two continuous variables).

Results: Constant’s score in the operated group was 57.1±19.3 and 58±21.5 in the conservative group. Union was noticed in all the operated patients, and there was one case of nonunion in the conservative group. There were no cases of AVN in any group.

Statistical Analysis: No significant difference between the two groups was found for total Constant’s score. ROM was similar in both groups except for the rotations, which tended to be better in the operated group: IR 7.6±2.6 versus 5.4±3.3 (p=0.103) respectively, ER 7.7±3.1 versus 6±2.6 (p=0.169) respectively.

Conclusions: Clinical results are similar for operative and conservative treatments in 3 part fractures of the proximal humerus. There are better results for rotations in the operated group. Strength in abduction is superior in the conservative group.

The difference could be influenced by the shorter follow–up period in the operated group.