A 15 cm long slightly curved skin incision, starting just cranial to the acromion process of the scapula, is made in distal direction towards the greater tubercle.
The brachiocephalicus and supraspinatus muscles are separated and retracted with the help of a self-retaining retractor (Weitlaner or Gelpi). At that point a periosteal elevator can usually be placed directly into the fracture plane.
The attachments on the lateral surface of the fragment are completely peeled off by sharp dissection.
The image shows the suprascapular nerve isolated and protected by a Penrose drain (arrow).