• Modified arthroscopic loop titanium plate fixation yields superior short-term clinical outcomes compared to clavicular hook plate for acute Rockwood III-V acromioclavicular dislocations, with higher excellent-to-good rates (94% vs 82%).
• The loop titanium plate technique is minimally invasive, resulting in shorter incisions, less blood loss, and lower postoperative pain, but requires longer operative time and higher hospitalization costs.
• Radiographic restoration of coracoclavicular and acromioclavicular distances is significantly better with the loop titanium plate, and the total complication rate is lower (6% vs 12%).
• Despite higher initial costs, the loop titanium plate may offer long-term economic benefits by reducing the need for secondary surgery, making it a viable option for patients prioritizing cosmetic and functional outcomes.