A series of 41 patients (average age 34 years) with acute acromio-clavicular joint separation were treated from 1985 to 1993 by temporary coraco-clavicular transfixation screw. The screw secures the anatomical position of the clavicle until the coraco-clavicular and the acromio-clavicular ligaments are healed. Follow-up was possible in 25 patients. The examination consisted in clinical and radiological evaluations, including assessment of subjective well-being: 24 patients were satisfied, while 1 patient complained of minor pain at work. Follow-up X-rays revealed mild subluxation of the acromio-clavicular joint in 5 patients and slight acromio-clavicular diastasis in 2. In 10 patients we found ligamentous calcifications. All patients had normal shoulder function. Seven patients had enlarged scars. Our good results indicate that this procedure can be recommended.