Periosteal elevator and/or bone hook
If closed reduction is unsuccessful, minimally invasive open reduction can be attempted through a small transdeltoid incision using appropriate instruments.
Periosteal elevators or punches can be used to disimpact and reposition fracture fragments.
If the reduction is not adequate, a similarly inserted bone hook may aid reduction of the tuberosities.
Protect the axillary nerve on the deep surface of the deltoid muscle, 6 cm below the acromion.