ObjectiveTo compare the effectiveness of triple Endobuttons and clavicular hook plate fixation in the treatment of fresh acromioclavicular joint dislocation (Rockwood type III-V). MethodsBetween February 2008 and October 2010, 40 patients with fresh acromioclavicular joint dislocation (Rockwood type III-V) were treated with triple Endobuttons in 18 cases (trial group) and with clavicular hook plate in 22 cases (control group). There was no significant difference in gender, age, disease duration, joint dislocation classification, preoperative visual analogue scale (VAS) score and Constant-Murley score between 2 groups (P gt; 0.05). ResultsAfter operation, wound healed by first intention with no early complication of infection or neurovascular injury. The patients were followed up 12-20 months (mean, 15.8 months) in trial group and 13-24 months (mean, 17.2 months) in control group. Significant differences were found in the VAS score and Constant-Murley score at the last follow-up between 2 groups (P lt; 0.05). X-ray films showed no loosening of internal fixators or hook displacement occurred. No re-dislocation was observed. ConclusionTriple Endobuttons has less shoulder pain and better shoulder motion than clavicular hook plate, so it is an effective method of treating Rockwood type III-V fresh acromioclavicular joint dislocation.