Some surgeons prefer to repair severe grade three AC separations, especially in high-level throwing athletes. The surgery is usually done through a four inch incision over the AC joint. The surgeon starts by putting the joint into its correct position. A screw or some other type of fixation may be used to hold the clavicle in place while the ligaments heal. The procedure can sometimes be done arthroscopically.
To fix the joint using a screw, the surgeon inserts the screw through the top of the clavicle and into the coracoid process. When a screw is used, it is usually removed six to eight weeks after the surgery. If it is not removed, the screw may break.
Some surgeons use surgical tape to connect the clavicle and coracoid. A small drill hole is made in the clavicle and corocoid. The surgical tape is looped through each hole and pulled snugly.
In some cases, sutures are also used to repair and reinforce the torn coracoclavicular ligaments.