Abstract: [Objective] To investigate the clinical outcome of open reduction and internal fixation (ORIF) of three-part and four-part injuries of superior shoulder suspensory complex (SSSC). [Methods] A retrospective study was conducted on 11 patients who received OR-IF for three-part and four-part SSSC injuries in our hospital from August 2016 to December 2021. The clinical and imaging data were evaluated. [Results] All patients had ORIF performed successfully without neurological or vascular injury, and were followed up for an average of (28.9±3.9) months. With time 1 month, 3 months postoperatively and the last follow-up, the VAS score [(7.0±1.5), (3.8±1.5), (1.8±1.0), P＜0.001]. Constant Murley score [(26.6±3.2), (40.9±2.9), (54.4±2.9), P＜0.001], forward flexion and elevation range of motion (ROM) [(94.3± 9.6)°, (127.0±6.4)°, (145.8±6.7)°, P＜0.001], abduction and elevation ROM [(75.7±6.5)°, (92.8±5.3)°, (115.2±5.9)°, P＜0.001] and internalexternal rotation ROM [(14.2±2.3)°, (32.4±3.1)°, (59.5±7.1)°, P＜0.001] were significantly improved, and no complications such as infection and bone nonunion occurred. Regarding imaging, there was no significant change in postoperative AHD (P＞0.05), and all fractures were bony union. [Conclusion] For the three-part and four-part injuries of SSSC, open reduction and internal fixation do restore the bone structure and stability of SSSC, and regain shoulder function well, so it is recommended to be the first choice of treatment.