Fifteen patients with Neer type II distal clavicle fracture were treated surgically. Operative treatment included open reduction and fixation of the proximal clavicular fragment to the coracoid process using a 6.5-mm cancellous screw and repair of the coracoclavicular ligaments. Fracture union occurred at a mean of 7 weeks postoperatively without any serious complications. All patients returned to the pre-injury level of activity with no residual pain or dysfunction.