ackground: Unstable distal clavicular fractures are challenging injuries associated with significant complications and functional limitations. Various surgical techniques have been employed to achieve stable fixation and promote early rehabilitation. However, the and Methods: A prospective study was conducted on 38 patients who underwent surgery for unstable distal clavicular fractures at a Department of Orthopaedic Surgery, Adunik Shador Hospital, Natore, Rajshahi, Bangladesh from November 2019 to July 2022. To evaluate the outcomes of surgical interventions for optimal approach for managing these fractures remains a topic of debate. Objective: The objective of this study was to evaluate the surgical outcomes of a novel approach for unstable distal clavicular fractures. Materials Neer type II clavicular fractures in a cohort of 38 patients. The average age of the patients was 42.9 years. Two different treatment approaches were utilized: a hook-plate was used in 22 patients, while a superior locked plate with suture augmentation was employed in 16 patients. Based on the timing of surgical intervention, patients were divided into two groups: acute treatment group (27 patients) receiving surgery within 4 weeks of injury, and delayed treatment group (11 patients) receiving surgery after 4 weeks. Clinical and radiographic follow-up was performed for one year or until fracture union was achieved.