We retrospectively reviewed cases of 19 of 35 patients who underwent operative treatment for type II fractures of the distal clavicle over 7 years. The average age was 21.5 years. There were 15 males. Ten of the fractures occurred in vehicular accidents and eight in sports. Ten of the fractures were comminuted. All fractures were closed. Thirteen patients were treated with transacromial Kirschner wires and six by other methods. There were 10 satisfactory and nine unsatisfactory results. All six nonunions and five of the six deep infections occurred in those treated with transacromial wires. Our results indicate that transacromial wire fixation may not be the treatment of choice for this uncommon fracture.