Proximal humerus fracture is a common fracture, mostly in elderly patients. Due to osteoporosis in elderly patients, it is difficult to treat displaced fractures larger than 1M and comminuted fractures. Conventional internal fixation methods such as Clinique pins, T-plates and trefoil plates are difficult to achieve effective fixation because the osteoporotic bone cannot provide a solid anchorage point for internal fixation and internal fixation failure occurs. For osteoporotic proximal humerus fractures, locking plates are an effective and firm method of internal fixation. The advantages of locking plate: (1) The plate adopts anatomical design, which does not require pre-curvature during surgery, reduces the damage to soft tissues, facilitates the recovery of shoulder function after surgery, and minimizes the impact on the acromion. (2) The plate adopts locking hole and general pressurized hole design, the proximal screw hole adopts locking screw hole design, and the direction of the hole is angular design, so that there is angular stability between the plate and the screw, allowing earlier functional exercise after surgery; the distal end of the plate adopts combined hole design, that is, the distal screw can adopt locking screw and also adopt pressurized tension screw, which can be used to achieve indirect fracture repositioning through the use of tension screw. The fracture can be indirectly repositioned through the use of tension screws, which can be used flexibly intraoperatively. (3) The proximal humeral locking plate is actually a kind of internal fixation frame because of the angular stability between the screw and the plate, so the plate does not need to be completely tightly bonded with the bone when the fracture is fixed and does not need to produce damage to the periosteum, which can achieve both fracture fixation and stability, reduce the damage to bone blood flow and facilitate fracture healing. (4) The plate is designed with suture holes at the proximal end, which is conducive to the fixation of large and small tuberosities, and allows reconstruction for rotator cuff injuries. (5) Compared with the ordinary plate, the incision of the locking plate is small, often requiring only a small incision before inserting the plate, and each locking screw of the locking plate can also be drilled through the skin with the aid of a guide and fixed in the bone by means of a splice plate, reflecting the principle of minimally invasive surgical techniques. (6) The locking of screws curbs the slippage withdrawal of screws and reduces the incidence of screw dislodgement, the most common complication of internal fixation of fractures. However, with the widespread use of locking plates, reports of internal fixation failure have gradually attracted attention. Combined with surgical experience, we feel that the following points should be noted: First, the placement of the plate. It should be placed about 5L distal to the greater tuberosity of the humerus and 10L posterior to the inter tuberosity groove. If it is too close to the end, it is easy to cause subacromial impingement during shoulder abduction, and if it is too distal, the number of locking screws used for effective fixation in the proximal fracture segment will be reduced, causing internal fixation failure; secondly, it reduces the stripping of soft tissue of the fracture block and protects its blood flow. Locking plate is only to fix the rod close to the bone surface, joint plate in the bone surface without contact and compression, to maximize the protection of the blood supply of the fracture block, to prevent fracture non-union and ischemic necrosis of the humeral head; third, the fracture site is severely osteoporotic, when dealing with fracture fixation, the proximal end of the fracture is fixed with at least 4 to 5 locking screws, and the distal end of the fracture is fixed with 3 to 4 locking screws, to increase the holding force and stability, to prevent The locking plate has good anchoring force and high tensile strength, unique angular stability, and the fracture gets stable after fixation, too conservative to postpone shoulder exercise, which is easy to cause shoulder periarthritis and affect joint function. In conclusion, through locking plate treatment of osteoporotic proximal humerus fracture, we feel that this internal fixation method has the advantages of easy operation, less surgical trauma, less blood flow destruction, good fracture healing, firm fixation, and early functional exercise, especially making it more advantageous for the fixation of osteoporotic fracture, and it is the ideal fixation method for the treatment of osteoporotic proximal humerus fracture at present.