The authors report 136 fractures involving the proximal humerus in children (two-thirds with fractures of the proximal metaphysis, one-third with fractures of the epiphyseal growth plate). Functional and anatomical results are studied in 52 patients with a mean follow-up of 5 years (range 1–18 years). The results are compared with reports in the literature. Usually, treatment should not be operative. Surgical approach in older children with irreducible lesions is discussed.