We report about our experience using elastic stable intramedullary nailing for markedly displaced proximal humeral fractures Type III and IV in children. A total of 25 children (mean age: 12.9 years) with 11 epiphyseal type Salter-Harris II and 14 metaphyseal fractures of the proximal humerus underwent intramedullary nailing, using single and double nailing techniques. The following complications occurred: one nail perforated the humeral head, one nail was placed in the wrong position, two problems occurred with the removal of the nail. At follow-up after 22 months we used the Constant-Murley score. We found an average result of 98 points (94-100). All children could carry out their sports activities like before the accident.