Objective To discuss the surgical approaches t o treat the 3-and 4-part-fractures of the proximal humerus in young adults.Methods Open reduction,internal fixation with T-shaped steel plate or together with tension band wire,repair of rupture d rotator cuff and joint capsule were conducted.Early rehabilitation wa s performed after the operation.Results8cases were followed up for 1to 4years,with an average of 3years.The functional recovery of the injured shoulder joint had an excellent result of 87.5%.Conclusions Internal fixation with T-shaped steel plate or together with tension band wire to treat the 3-and4-part-fractures of the proximal hu merus in young adults can better the function al recovery of the shoulder joint,as long as used properly,because it is s table and eliminates the need of postoperativ e external fixation so that function al exercises can be done earlier.