Three- and four-part proximal humerus fractures are complex injuries that are common in the elderly population. Possible surgical treatment includes closed reduction percutaneous pinning, open reduction internal fixation, hemiarthroplasty, and reverse shoulder arthroplasty. The use of reverse shoulder arthroplasty is becoming increasingly popular for this injury due to often unpredictable and poor outcomes provided by other surgical options. Numerous comparative studies demonstrated better functional outcome and pain relief of reverse shoulder arthroplasty. Good results rely on understanding of anatomy, preoperative planning, and attention to technical details, such as robust repair of the greater tuberosity fragment.Quick Tips