Study Summary

80 patients (older than 60 years) with displaced proximal humeral fractures were randomized in a 1:1 ratio to receive either nonoperative treatment or operative treatment with locking plate fixation. Four patients randomized to surgery did not undergo the operative intervention due to preoperative clinical contraindications. At 24 months, 71 patients completed follow-up and were included in the analysis, with 40 patients in the nonoperative group and 31 patients in the operative group. The primary outcome was the Constant–Murley score at 24 months. Secondary outcomes included the Individual Relative Constant Score, American Shoulder and Elbow Surgeons (ASES) score, and Single Assessment Numeric Evaluation (SANE) score assessed at 3, 6, 12, and 24 months, as well as complication rates and need for additional surgery. Outcomes were assessed up to 24 months post-injury. Overall, the results of the study revealed no statistically significant differences in shoulder function between nonoperative and operative treatment groups at any follow-up time point, while complication rates were numerically higher in the operative group.