There is a paucity of high-quality clinical and basic-science data regarding the bone of the shoulder girdle. A comprehensive understanding of this topic will improve risk stratification for scapular spine and acromial fractures following reverse total shoulder arthroplasty, and more broadly, osteoporotic fractures of the proximal humerus and scapula. Findings from these investigations will also enhance prevention and management practices, thereby decreasing the morbidity and mortality associated with these fractures.