Objective To explore the efficacy of combination of anatomical locking plate and suture anchor fixation and clavicle hook plate fixation in the treatment of NeerⅡb distal clavicle fractures. Methods The data of 106 patients with NeerⅡb distal clavicle fractures were collected for retrospective analysis. According to different treatment regimens, the patients were divided into control group (clavicle hook plate fixation, n=52) and combined group (anatomical locking plate+suture anchor fixation, n=54). The fracture healing status, perioperative indicators, swelling degree and pain status at 7 days after surgery, shoulder function ［Constant-Murley scoring standard, Disability of Arm Shoulder and Hand (DASH)］ at 3 and 6 months after surgery and occurrence of complications were compared. Results There was no obvious difference in the number of fracture healing cases between the two groups after 6~12 months of follow-up (P＞0.05). Compared with the control group, the fracture healing time in the combined group was shortened (P＜0.05), and the incision length was reduced (P＜0.05), but the surgical time, intraoperative blood loss, hospital stay and swelling degree and pain score at 7 days after surgery were not obviously different in comparison with the control group (P＞0.05). At 3 months after surgery, the Constant-Murley score was obviously higher (P＜0.05) while the DASH score was significantly lower in the combined group compared to the control group (P＜0.05). At 6 months after surgery, there were no statistical differences in the above scores (P＞0.05). The incidence rates of peri-acromial pain, subacromial impingement syndrome and fracture delayed union revealed no significant differences between the two groups (P＞0.05).Conclusion During treatment of Neer Ⅱb distal clavicle fractures, anatomical locking plate combined with suture anchor has a significant efficacy, and its fracture healing time is shorter than that of clavicle hook plate fixation, and the shoulder function can be restored faster