C1.1 fractures (slightly valgus displaced anatomical neck fracture with associated tuberosity fracture) need to be properly reduced in order to achieve good results in terms of stability, function and pain relief. The anatomic neck fracture is fairly stable. The periosteum is typically not ruptured and the risk of an avascular necrosis is reduced.
Operative fixation is the preferred treatment. The choice of fixation depends upon the surgeon’s experience and skill, the available implants, and equipment. 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. The results of nonoperative treatment can be satisfactory.