Pearls

Type I: Most distal, lateral to CC ligaments. Non-operative.
Type IIA: Medial to CC ligaments. Operative.
Type IIB: Between CC ligaments. Operative.
Type III: Intra-articular, lateral to CC ligaments. Non-operative.
Type IV: Pediatrics, physeal fracture. Non-operative.
Type V: Comminuted fracture with intact CC ligaments. Operative.

Generally, distal fractures between acromioclavicular (AC) joint and coracoclavicular (CC) ligaments can be treated conservatively.
Fractures proximal to the CC ligaments or with significant displacement are typically unstable and require operative fixation.