Abstract: Objective:To explore the clinical effects of the artificial humeral head replacement in the treatment of complex proximal humeral fractures.Methods:Fourteen elderly patients with proximal comminuted fracture of the humerus were treated with humeral head replacement.The distance between the lowest point of great tuberosity of humerus and highest point of the humeral head in unaffected side before operation was measured.Reasonable controlling the prosthesis depth,paying attention to the angle,reducing large and small tuberosity and repairing the rotator cuff were implemented before treatment,and the personalized plan of rehabilitation exercise were formulated after operation.Results:Fourteen cases were followed up for 3 to 70 months,all patients could do the ordinary daily action.Excellent in 5 cases,good in 7 cases and moderate in 2 cases were identified according to Neer scores,the rate of excellent-to-good was 85.7%.Conclusions:Strict controlling the indications,good prosthesis installing,repairing the rotator cuff,planned rehabilitation exercises and humeral head replacement is a good method in treating complex proximal humerus fractures in elderly.