250 patients with displaced fractures of the proximal humerus involving the surgical neck were randomly assigned to receive either surgical or non-surgical intervention as treatment. The purpose of this study was to compare functional and clinical outcomes, as well as cost-effectiveness, between the two methods to determine if surgery offers any significant advantage over conservative treatment. The results demonstrated no significant difference in Oxford Shoulder scores (OSS) between groups, while surgery demonstrated lower cost-effectiveness than non-surgical treatment over the entire 2 year period.