These fractures should be properly reduced to achieve good results in terms of stability, function and pain relief. The anatomical neck fracture is fairly stable. The periosteum is typically not ruptured and the risk of avascular necrosis is reduced.
Operative fixation is the preferred treatment. However, the decision for surgery should also include the functional demands of the patients, the presence of comorbidities and the ability to undergo operative treatment.
Nonoperative treatment of minimally displaced fractures is largely satisfactory. Watch for significant prominence of the greater tuberosity which may produce painful limited motion through coraco-acromial impingement.