Medical interventions, including the decision not to treat, impact the patient’s health and well-being. Every surgeon aims to do no harm and to provide the best care for the patient—but every surgical procedure inflicts damage on the patient. Knowing that, the good surgeon weighs the anticipated harm against the potential benefits. If the potential benefits of a surgical intervention outweigh the expected harm, surgery can be considered an option. It is essential to avoid biased weighting based on strong preferences, as this may harm the patient. To facilitate evidence-based practice in modern fracture management, reporting complications consistently using well-defined terms is necessary. A brief overview of the current terms and definitions related to complications after shoulder fractures is presented. A group of international shoulder experts has proposed a core event set based on consensus on unfavorable events. Proposed consensus-based definitions for radiological monitoring parameters are presented. The use of radiologically defined complication terms as proxies for patient outcome is questioned.