To determine reoperation rates after treatment of a proximal humerus fracture with cage fixation. Retrospective case series. Eleven U.S. hospitals. Fifty-two patients undergoing surgical treatment of proximal humerus fractures. Open reduction and internal fixation of a proximal humerus fracture with a proximal humerus cage. Reoperation rate at 1 year. At a minimum follow-up of 1 year, reoperations occurred in 4/52 patients (7.7%). Avascular necrosis (2/41) occurred in 4.9% of patients. Standard locked plating remains an imperfect solution for proximal humerus fractures. Proximal humerus cage fixation had low rates of revision surgery at 1 year. Proximal humerus cage fixation may offer reduced rates of complication and reoperation when compared with conventional locked plating for the management of proximal humerus fractures. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.