SummaryShoulder disorders are very common in the older population. These can be traumatic injuries such as proximal humerus fractures, or degenerative pathology, with rotator cuff disease being the most frequently diagnosed. Lower functional demands along with the presence of co-morbidities means that conservative management is usual. However, surgery can provide pain relief and improve functional outcomes in selected patients. A thorough pre-operative assessment should be performed to avoid surgical or post-operative complications. Osteoporosis is the major concern when undertaking bone fixation in orthopaedic implants and should be routinely ruled out and treated in order to achieve better results.