143 patients undergoing treatment for acute proximal humeral fractures (PHF) were randomized to receive either an X-ray assessment one week after treatment or no X-ray assessment. Outcomes of interest included pain on a Visual Analog Scale (VAS), Constant score, Simple Shoulder Test (SST), the incidence of complications such as stiffness and avascular necrosis, and the need for further surgery. The results indicated no significant differences in VAS scores, Constant scores, and SST between the two groups at any of the time points measured. One patient in the X-ray group required surgery at 10 months due to avascular necrosis, but no other patient in either group required further surgery or a change in the treatment regimen. There were 10 complications reported equally between both groups.