We reviewed 31 patients who underwent modified Bosworth procedures for grade III acromioclavicular dislocation. Their average age at the time of surgery was 32.5 years (range 18-60 years) and the mean follow-up was 11.6 years (range 5-20.6 years). The operation was performed for young, active individuals engaged in heavy manual work, in those who wished to return to contact sports and in patients with prominent clinical deformity. The results were analysed using the criteria suggested by Imatani et al. (1975). Of the patients, 24 (77 per cent) had excellent or good results and seven (23 per cent) had fair or poor results. There was no correlation between the radiological findings and the clinical results.