A 65-year-old hypertensive male came to the emergency department with swelling and tenderness over left shoulder and left arm following a high velocity road traffic accident. He sustained a direct impact of the shoulder and arm of the left side over the ground. There was no open wound and no neurovascular deficit in the affected upper limb. Initially, a U shaped POP slab with sling was given. Plain radiographs of left shoulder and left arm showed displaced mid third clavicle fracture with acromioclavicular joint dislocation type 3 (Rockwood classification) with mid shaft humerus fracture [,,]. After complete pre-anaesthetic check up and after obtaining informed consent, surgical fixation was scheduled. First humerus fixation with interlocking nail, followed by clavicle fixation with reconstruction plateand then reconstruction of coracoclavicular ligaments for stabilization of the acromioclavicular joint was planned.