PURPOSE: To review clinical and radiological results after open reduction and internal fixation with T plate for unstable distal clavicle fractures. MATERIALS AND METHODS: From July. 1999 to December 2002, nine patients with distal clavicle Neer type II fractures were treated by open reduction and internal fixation with T plate. The bony union was confirmed by plain radiography. The clinical results were analyzed according to the classification by Kona et al. RESULTS: Average time to fracture union was 8 weeks in all cases. The functional results were as follows: excellent in 7 cases and good in 2 cases. Screw loosening occurred in one case, but bony union was achieved. CONCLUSION: We recommend T plate fixation as another treatment method for unstable distal clavicle fractures.