Abstract:[Objective] To compare the clinical efficacy of double-loop Endobutton plates and clavicular hook plate for acute acromio-clavicular dislocation. [Methods] A retrospective study was conducted on 44 patients who received surgical treatment for Rockwood typeIII or more severe type acute acromioclavicular dislocation in our hospital from January 2019 to June 2021. Based on surgeon-patient dis-cussion, 21 patients received double-loop button plates fixation (the DLB group), while other 23 patients underwent hook plate fixation (theHP group). Perioperative period, follow-up and imaging data of the two groups were compared. [Results] Although there were no significantdifferences in operation time, intraoperative blood loss and active activity time between the two groups (P＞0.05), the DLB group proved sig-nificantly superior to the HP group in terms of incision length [(5.3±0.6) cm vs (6.2±1.1) cm, P=0.002] and hospital stay [(8.1±1.6) days vs(9.6±2.8) days, P=0.042]. As time went on in the follow-up period lasted for (14.5±3.3) months on an average, the VAS and Constant-Mur-ley scores, as well as shoulder forward flexion-uplifting and abduction-uplifting range of motions (ROMs) significantly improved in bothgroups (P＜0.05). There was no statistical significance in the abovesaid items before operation (P＞0.05), but the DLB group was significantlybetter than the HP group 3 months postoperatively and at the last follow-up in terms of VAS score [(2.1±0.7) vs (3.4±0.7), P＜0.001; (1.0±0.7) vs (2.4±0.8), P＜0.001], Constant-Murley score [(80.8±3.3) vs (69.4±5.0), P＜0.001; (90.0±3.1) vs (80.4±5.8.), P＜0.001], forward flex-ion-uplifting ROM [(147.6±7.0)° vs (117.4±8.1)°, P＜0.001; (171.9±6.8)° vs (153.0±9.1)°, P＜0.001] and abduction-uplifting ROM [(140.0±7.7)° vs (99.1±6.7)°, P＜0.001; (165.7±5.1)° vs (140.4±8.2)°, P＜0.001]. With respect of imaging, the postoperative coracoclavicular distanceand acromioclavicular distance were significantly decreased in both groups compared with those preoperatively (P＜0.05), whereas whichwere not statistically significant between the two groups at any time points accordingly (P＞0.05). [Conclusion] The double-loop button plates have advantages of smaller surgical incision, better shoulder function recovery, less complication rate, and no need to remove the im-plant secondarily over the hook plat , therefore, the double-loop button plates maybe a better choice for the treatment of acute acromiocla-vicular dislocation.