[Objective] Analyze the clinical results of two surgical methods in the treatment of juvenile proximal humeral fractures.[Methods] In this retrospective study，we reviewed 71 cases of the significantly displaced proximal humeral fracture treated by surgery between August 2010 and May 2018. According to different internal fixation method，they were divided into percutaneous K-wire group(34 cases) and ESIN group(37 cases) .The preoperative，follow-up and radiographic documentations were analyzed and evaluated. [Results] All patients underwent surgical smoothly without neurovascular injury.Two post-operative pin site infection occurred in K-wire group.The K-wire group was superior to the ESIN group in operation time、incision length、fluoroscopic time and hospital stay,the statistical significance was proved in operation time、incision length and fluoroscopic time between two groups（p< 0.05）.All cases in two groups achieved bony union without malunion or physeal arrest.No significant difference was seen between the groups for the shoulder joint ROM, mean DASH or Constant-Murley scores at three months after surgery and the final follow-up （p>0.05）. With respect to radiographic evaluation,there were no significant difference in the fracture reduction quality and fracture healing time between the two groups（p>0.05）. The neck-shaft angle was significantly improved by reduction postoperatively in both groups (P < 0.05）.[Conclusions] Close reduction with K-wire pinning or ESIN both have favorable and comparable functional outcomes and therefore seem to be adequate methods for treating significantly displaced proximal humeral fractures in juvenile patients.