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1. Screw fixation of clavicle to coracoid process, with subsequent calcification and ossification along the conoid and trapezoid ligaments, creates an extra-articular fusion of the acromio-clavicular joint.

2. Though the follow-up is admittedly early, excellent results can be obtained in the young healthy adult. It is possible to return an athlete to competitive sports and a heavy labourer to full work in a surprisingly short time.

3. The operation is of doubtful value in older patients.

4. A precise operative technique is most important in producing a successful result.

5. Screw fixation introduces a new movement into the abduction mechanism of the shoulder: synchronous scapulo-clavicular rotation.

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