30 cases have been collected and treated by the authors. They classify the anatomical types according to the direction and nature of the fracture line. The treatment is more difficult when the fracture is intra-capsular than when it is extra capsular, that is metaphysial or below the tuberosities. A particular type was described, called "vertical fracture" by the authors. The major complication was a persistent joint stiffness, commonly bound to an avascular necrosis of the humeral head, especially in intra-capsular fractures. An orthopaedic reduction should always be attempted when the fracture is impacted. In the other cases, the treatment should be surgical aiming at obtaining a reduction of the dislocation and fixation of the fracture. The opportunity of an early arthroplasty in intra-capsular, comminuted fractures with extruded capital fragments is discussed.