In 1951 a shoulder prosthesis was developed for the treatment of complex humeral head fractures by Neer. The Neer-II-Prosthesis, which was developed further in 1973 represents the basis of modern shoulder implants. The unsatisfactory postoperative functional results for primary humeral head replacement required the development of new adaptable implants for the treatment of complex humeral fractures, which allow the reconstruction of humeral length, the reconstruction of center of rotation and humeral offset, the anatomic positioning, the reconstruction of retrotorsion and the secure refixation of the tuberosities. The development of third and fourth generation of humeral head prosthesis achieves a three-dimensional adaptability for the conditions of posttraumatic arthritis. Primary and secondary humeral head replacement in humeral head fractures as well as revision of prosthetic replacement are complex and technical demanding operations with high and different requirements on implants having to be realised on further development.