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The ability to reproducibly achieve a predictable result for a hemiarthroplasty in a proximal humerus fracture is multifactorial. However, functional outcome studies invariably identify inadequate tuberosity reconstruction as one of the primary causes of poor functional outcome. It is also critically important to recognize that the proper placement of the humeral component at the correct height and in the proper amount of retroversion is critical to the ultimate stability of the greater tuberosity repair and eventual outcome of the procedure. The goal of the present article is to describe a technique for tuberosity reconstruction in hemiarthroplasty for proximal humerus fractures with an emphasis on achieving secure, anatomic tuberosity fixation.