The deltopectoral approach to the shoulder is typically the approach used in trauma surgery around the shoulder. Mackenzie described an anterosuperior approach to the shoulder to optimize insertion of the components for a total shoulder replacement; he attributed this approach to Nevasier. This approach has recently been popularized for the Copeland resurfacing and Delta reverse-geometry prostheses. Using a modification of this approach, we describe its use in a group of patients requiring either internal fixation or hemiarthroplasty for proximal humeral fracture and the effect of this approach on the postoperative function on the axillary nerve and deltoid muscle. This article aims to show its usefulness as an alternative approach in trauma surgery of the shoulder.