Nonoperative treatment (accepting the deformity with early range of motion and strengthening exercises) was compared with surgical treatment by Bosworth claviculocoracoid screw fixation of complete acromioclavicular dislocations. Nonoperative treatment provided an equal if not superior result, with an earlier return to activities, sports, and work. Neither the "bump" nor the scar was a significant cosmetic complaint. Range of motion and strength were equal, despite the treatment. Both groups were significantly weak in shoulder external rotator muscle power.