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Arch Orthop Trauma Surg In our study, good results were achieved after resection arthroplasty and reconstruction of the SCJ. Statistical analysis revealed that the long term results using ASES-, DASH- and Constant–Murley Score for evaluation did not signiWcantly diVer both after SCJ reconstruction or after resection arthroplasty (Mann–Whitney test P < 0.05). No diVerences were seen when comparing postoperative instability in the two groups. In our study, the reconstruction group complaint signiWcantly less postoperative pain than the resection group. Equivalent postoperative results were obtained in the reconstruction group when the SCJ reconstruction was performed soon after injury. Because of limited cases, diVerences in demographic data (mean age or sexual distribution) in the groups were not avoidable. Additionally, the mean follow-up period after reconstruction (13 years) was longer than after medial resection (6.9 years). However, we believe that the followup was suYcient to represent long-term results. Our long-term follow-up study showed that good postopertive treatment results could be obtained after SCJ reconstruction or after resection arthroplasty. We recommend in acute instable cases reconstruction of the SCJ and in chronic, painful cases a medial resection of the clavicle. A disadvantage of all studies continues to be the limited study populations. Because of the small numbers of cases, an optimal, standardized operative procedure is diYcult to establish. Multicenter studies may help to increase the number of individuals in order to create homogenic patient groups for further outcome analysis. References 1. Allman FL (1967) Fractures and ligamentous injuries of the clavicle and its articulation. J Bone Joint Surg Am 49:774–784 2. Bankart ASB (1938) An operation for recurrent dislocation (subluxation) of the sternoclavicular joint. Br J Surg 26:320–323. doi:10.1002/bjs.18002610211 3. 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