We reported the relationships between the initial radiogram findings and bone union in surgical neck fractures of the humerus. The purpose of this study was to inspect the relationships between the initial radiogram and bone union and also the shoulder ROM. Between May 2005 and February 2008, 80 humeral surgical neck fractures were treated according to the treatment protocol based on the previous study. When the displacement of the fracture was none and/or less than 1/4 of their diameter in two direction in the initial radiogram, conservative treatment was selected. When the displacement was more than 1/4 in at least one direction in both displaced cases, internal fixation was considered. The relationship of the initial radiogram findings and bone union, ROM and JOA score was examined. More than 90% had bone union in the cases in which their displacement was none or less than 1/4 of their diameter in both the two directions. The mean ROM (flexion, abduction, external rotation) were ; no displacement cases: 136°, 147°, 49°, <1/4 displacement in one direction cases: 115°, 118°, 39°, <1/4 displacement in two direction cases: 109°, 120°, 30°. JOA scores were 88.3pts., 71.2pts., 90pts in each case. When the displacement in both two direction are less than 1/4 at initial radiogram in proximal humeral fractures we can expect bone union. When axis dislocation of the initial radiograms were less than 1/4 in two directions, the bone union rates were more than 90%, and elevation was possible to more than 120 degrees.
