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Twenty- seven patients underwent repair for acute injuries (&lt;3 weeks after injury) and 17 patients underwent recon structions for chronic injuries (&gt;3 weeks). Coracocla vicular fixation with heavy nonabsorbable sutures was used to correct superior displacement in all cases. In addition, transfer of the coracoacromial ligament to the distal clavicle was performed in 15 of the 27 early re pairs and 17 of the 17 late reconstructions. Overall, 26 of 27 (96%) early repairs and 13 of 17 (77%) late re constructions achieved satisfactory results. There was a trend for better results and return to sports or heavy labor with early repairs; however, this was not statisti cally significant (P = 0.065). When the results of early repairs were compared with those of late reconstruc tions performed more than 3 months after injury, the results of the shoulders undergoing early repair were significantly better ( P &lt; 0.01). Overall, 39 of 44 (89%) patients achieved a satisfactory result. 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