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. Fractures of the medial end of the clavicle in adults are uncommon, accounting for only 2-3% of all clavicle fractures. Traditionally, these fractures have been treated nonoperatively, even when significantly displaced, with operative intervention reserved for open fractures, neurovascular involvement, or threatened overlying skin. The literature is sparse on medial end fractures, but the results of available studies suggest that nonoperative treatment of displaced fractures is often unsatisfactory. Some have reported that up to half of all patients are still symptomatic more than a year after injury, while others have shown a nonunion rate approaching 15%. To our knowledge, no study to date has reported on the outcome of operative intervention specific for displaced, medial end clavicle fractures. This study reports on 5 patients who had open reduction and internal fixation (ORIF) of a displaced, medial end clavicle fracture.