60 patients with type III-IV acromioclavicular joint dislocation were randomized to either surgical intervention with open reduction and tunneled suspensory device fixation (ORTSD group) or to nonoperative treatment. The purpose of this study was to compare disability and function over the first year of follow-up. Results on the Disabilities of the Arm, Shoulder, and Hand (DASH) score and the Oxford Shoulder Score significantly favoured the ORTSD group compared to the nonoperative group at 6 weeks, though by 1 year, differences between groups were not significant.