The results following nonoperative treatment of displaced, medial end clavicle fractures is often unsatisfactory; but no study has yet reported the outcome of operative fixation of these fractures. This study reports the results of open reduction and internal fixation on displaced, medial end clavicle fractures, in five adult patients (aged 25-52 years, mean 43) including 1 patient with a nonunion. The mean follow-up was 3.3 years (8 months-10.3 years). All fractures had united clinically and radiologically. No complications occurred, and no revision surgery was required. VAS pain scores averaged 0.75 (0-2) at rest, 0.75 (0-2) for normal activities, and 1.0 (0-2) for heavy activities. The mean DASH score was 9.0 (0-17), and all patients were very satisfied with the results of surgery (VAS 10). All patients had a full range of motion of their shoulder at final follow-up and were able to return to pre-injury occupational and activity levels.