Summary Results from three randomized controlled trials (one of these is included with the caveat that it is an e-publication accessed ahead of the published version) were consistent with respect to treatment of three and four part fractures of the proximal humerus.All studies found no significant difference in functional outcomes;however, complications were significantly higher in the osteosynthesis treatment arm compared with the conservative arm in the two recent reports.Small sample size and subsequent lack of power to detect a difference between treatments was problematic in all studies.Larger,randomized studies are needed to further elucidate whether there is a difference between treatments in terms of functional outcome.对于肱骨近端三或四部分骨折的治疗,3项随机对照研究(其中1项研究以电子版发表)的结论一致.所有研究均发现,不论选择手术治疗还是保守治疗,患肢功能的恢复差异无统计学意义.但是现有的2项研究认为,与保守治疗相比,手术治疗会明显增加并发症的发生率.由于现有的研究均为小样本研究,缺乏足够的病例来说明两种治疗方法间的差异,因此,需通过开展大样本的随机对照研究来明确不同治疗方法对功能的恢复是否存在差异。