This study investigated the effect of two surgical treatment schemes on complex proximal humeral fractures. We included 60 patients with complex proximal humeral fractures admitted to the People’s Hospital of Zhongjiang County, China, from May 2016 to May 2017. The patients were randomly divided into group A (30 cases; intramedullary nail fixation) or group B (30 cases; plate internal fixation) to compare the therapeutic effects. We used Neer’s scoring system to calculate an acceptability ratio and assess pain six weeks after surgery. The acceptability ratio was 80.0% in group A and 93.3% in group B, and the ratio did not differ between the groups (P>0.05). In groups A and B, 56.7% and 50% of patients were without pain, respectively; this rate did not differ between the groups (P>0.05). Our results indicate that both methods are suitable for treating complex proximal humeral fractures. However, in practice, surgeons should select the most appropriate treatment method based on the actual fracture to ensure the best postoperative outcome with the least amount of pain.