Fractures of the proximal humerus represent a typical injury of the elderly. Additional lesions of nerves or arteries are rare and there is only little information in the literature on the co-occurrence of proximal humerus fractures and compromised peripheral circulation which could lead to the loss of the upper extremity. To prevent damage to the injured limb, it is necessary to invent and initiate a standardized algorithm involving trauma care matching the special needs of this combined injury.