Open reduction and fixation of displaced lateral clavicle fractures using the Minimally Invasive Acromioclavicular Joint Reconstruction (MINAR®) technique: a case series review

Shoulder Elbow. 2015 Jan;7(1):13-7. doi: 10.1177/1758573214536535. Epub 2014 May 27.

Abstract

Background: Lateral end of clavicle fractures can be a challenge, with a 20% to 30% non-union rate if treated non-operatively. Several operative options exist, each having their own merits and some having potential disadvantages. The Minimally Invasive Acromioclavicular Joint Reconstruction (MINAR®) (Storz, Tutlingen, Germany) set uses an Orthocord (Depuy Synthes Mitek, Leeds, UK) suture and two Flip Tacks (Storz) via a transclavicular-coracoid approach to reconstruct the coracoclavicular ligaments.

Methods: Referrals were made to two senior surgeons at separate institutions regarding Robinson Type 3 fractures of the lateral end of the clavicle. All patients were treated with MINAR implant via a minimally invasive approach. Two-year follow-up was obtained using the Oxford Shoulder Score (OSS) and the Quick DASH (Disability of the Arm Shoulder and Hand) score.

Results: Sixteen cases of acute fractures of the lateral end of the clavicle were included in this series. At final follow-up, the mean OSS was 44.75 (range 35 to 48) and the median Quick DASH score was 2.3 (range 0 to 35.9). Fifteen patients achieved bony union (one asymptomatic non-union) and there were no complications or re-operations.

Conclusions: The MINAR is reproducible and safe when treating lateral end of clavicle fractures. We consider that, over the short- to mid-term, it achieves results equivalent to those for other implants.

Keywords: Clavicle fractures; DASH; MINAR; Oxford Shoulder Score; Robinson Type 3; complications; hook plates.