[Objective]To explore the causes and Treatment Countermeasures of internal fixation related complications in patients with proximal humerus fracture combined with greater tubercle fracture treated by open reduction and anatomical plate internal fixation.［Methods]From January 2018 to January 2021,a total of 114 cases of proximal humerus complicated with macronodular fracture treated by open reduction and anatomical plate internal fixation were collected.The related information and complications were collected to explore the causes and treatment countermeasures.［Results]The complication rate was 32/114 (28.1%),and the sequence of complications was screw penetration in eleven（9.6%）;Varus deformity in 9 cases(7.8%),subacromial impingement in 7 cases (6.1%);Malunion occurred in 3 cases (2.6%)and humeral head necrosis in 2 cases (1.7%).［Conclusion] The complications of proximal humerus combined with macronodule fracture treated by open reduction and anatomical plate internal fixation are high.The most common complications are screw penetration,varus deformity and subacromial impact.Paying attention to complications,improving surgical technology and improving bone quality are the key to reduce complications.