<p>This article discusses fractures of the upper third of the humerus in elderly patients within the context of diagnostic evaluation, fracture classification, biomechanics, and fracture occurrence, including osteoporosis. The shoulder joint is composed of the proximal humerus and the glenoid of the scapula. Very important factors for fracture incidence and patterns are osteoporosis and distribution of bone tissue and bone density in the proximal humerus. Most fractures are caused by fall from standing hight. Parts of diagnostic work-up and management plans are clinical examination, different imaging modalities and classification sistems.</p>