72 patients with a displaced 2- or 3-part proximal humerus fracture were randomized to operative management through either intramedullary nail fixation or locking plate fixation. The purpose of this study was to compare clinical outcome scores between groups, as well as radiographic results and complications, over 12 month follow-up postoperatively. Findings demonstrated no significant differences between groups in Constant and Murley Score, Disabilities of the Arm, Shoulder, and Hand (DASH) score, visual analog scale pain scores, shoulder range of motion, or radiographic results (union and head shaft angle) at 3, 6, or 12 months. Significantly higher incidences of complications and reoperation were noted with intramedullary nail fixation compared to locking plate fixation.