Various surgical procedures have been recommended for the treatment of complete acromioclavicular joint separations. The results have been similar in case reports by various authors. From 1984 to 1992, 35 patients were operated on for acromioclavicular joint separations (Tossy III) in the Department of Surgery, Marien-Hospital, Düsseldorf, using Balser's hook plate. The postoperative morbidity rate was 14.3%. Follow-up examinations were performed on 30 patients (85.7%) with average follow-up of 4.1 years, using a rating system that include subjective, objective, and roentgenographic criteria. Fifty percent of patients had no complaints, but residual dislocation was found in 36.7% of cases. While 26 patients (86.7%) were satisfied with the results of the operation, 30% demonstrated a fair result according to the scoring system. The complaints and clinical findings showed no correlation with the X-ray results, e.g. calcification or arthrosis, redislocations.