With the advent of the aging society the incidence of proximal humeral fractures PHFs in the elderly is increasing year by year It has been reported in the literature that 40 out of 100000 elderly peo

In summary, as the aging society continues to grow, the incidence of complex proximal humeral fractures in the elderly is increasing, causing varying degrees of disability, pain, and even death. While conservative treatment options have been effective in some cases, they may not be sufficient for complex three and four-part fractures. ORIF and HA have their limitations and may not result in satisfactory shoulder joint function and pain relief. RSA has shown promise in recent years, but clinical disputes still exist. Therefore, further evaluation and comparison of different interventions are necessary to determine the most effective and safe treatment for complex proximal humeral fractures in the elderly