Table 1 Inclusion and Exclusion Criteria

Inclusion Criteria

 1. Displaced 3-part proximal humerus fractures by the Neer classification; or displaced 4-part proximal humeral fractures by the Neer classification that are deemed amenable to surgical internal fixation

 2. > 60 years of age

 3. Low energy mechanism of injury

 4. Acute fracture^a

Exclusion Criteria

 1. 4-part proximal humerus fractures that are not deemed amenable to surgical fixation^b; fractures that are better suited to treatment with arthroplasty

 2. Isolated greater tuberosity fractures

 3. Ipsilateral upper extremity significant injury, concomitant fracture or polytrauma

 4. Open fracture

 5. Previous ipsilateral shoulder surgery

 6. Patients with active worker’s compensation claims^c

 7. Active joint or systemic infection

 8. Patients with convulsive disorders, collagen diseases, and any other conditions that might affect the mobility of the shoulder joint

 9. Major medical illness^d

 10. Unable to speak or read English/French

 11. Psychiatric illness that precludes informed consent

 12. Unwilling to be followed for 2 years