Bringing broken bones together is what our ancestors did and what we and our successors will do. Over the past 50 years, there has been a substantial increase in surgical options for shoulder fractures. A sharp rise in surgical activity has been driven by a strong belief in the benefits of surgery, a lack of awareness of the evidence, and effective marketing. Surgery has become the mainstream approach, and a tenacious adherence to surgery has developed. The main difference between modern orthopedic surgery and historical practices lies not in our advanced surgical techniques but in our ability to critically evaluate our methods and adjust accordingly. There is a widespread assumption that surgeons who excel academically may lack surgical skills, while those with excellent surgical skills do not need to follow the evidence. The modern orthopedic surgeon needs proficiency in both. This chapter discusses the tension between learned medicine and orthopedic practice in treating shoulder fractures. The debate dates back two millennia and continues to influence current discussions on evidence-based orthopedics. We must base our practice on the best available evidence, clinical expertise, and patient preferences and values to distinguish ourselves from historical bonesetters and illiterate practitioners.