title: Open reduction and fixation of displaced lateral clavicle fractures using the Minimally Invasive Acromioclavicular Joint Reconstruction (MINAR®) technique: a case series review.
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.
authors: Stepping Hill Hospital, Stockport, Manchester, UK.
authors: Peter
authors: P
authors: Kenyon
authors: Stepping Hill Hospital, Stockport, Manchester, UK.
authors: Barnes William
authors: BW
authors: Morgan
authors: Countess of Chester NHS Trust, Chester, UK.
authors: Mark
authors: M
authors: Webb
authors: Stepping Hill Hospital, Stockport, Manchester, UK.
authors: Darren
authors: D
authors: Ebreo
authors: Stepping Hill Hospital, Stockport, Manchester, UK.
authors: Andrew
authors: A
authors: Wheelton
authors: Stepping Hill Hospital, Stockport, Manchester, UK.
authors: Matt John
authors: MJ
authors: Ravenscroft
keywords: Clavicle fractures; DASH; MINAR; Oxford Shoulder Score; Robinson Type 3; complications; hook plates