Based on the shoulder symposia at the 2010 Annual Meeting in New Orleans, as well as the AAOS/ASES/OTA Proximal Humeral Fractures course held at the Orthopaedic Learning Center. Understand the advantages and disadvantages of ORIF, percutaneous pinning and intramedullary devices for the surgical treatment of proximal humerus fractures. Learn the common causes of rotator cuff repair failure and evaluate the transition to arthroscopic repair. Recognize the importance of bone loss in shoulder instability and explore treatment options with both open and arthroscopic approaches.