The goal of this study is to analyze the surgical management of proximal humerus fractures in medial age patients (50–65 years of age).

From 2003–2008 were treated 49 patients, 14 male and 35 female with mean age of 61 years. All patients had a proximal humerus fracture classified by the AO Universal Classification. The fractures were treated with either open reduction internal fixation (ORIF-21 patients) or with shoulder hemiarthroplasty (HSA-28 patients) under general anesthesia.

Among the patients that were treated with ORIF or HSA we did not observe statistical significant differences in the days of hospital stay, the change of pre and postoperative hemoglobin, the need of blood transfusion and the acute postoperative complications. On the contrary there were statistical significant differences in the level of acute postoperative pain, the clinical results and the range of shoulder movements after a period of 3,6 and 12 months (constant score).

ORIF seems to have better clinical results for younger medial age patients in comparison with HSA that seems to have poorer results. On the contrary HSA seems to have better clinical results for older medial age patients.