**Abstract**

Midshaft clavicle fractures are a common orthopaedic upper limb injury in young athletes and in trauma. While non-operative care has traditionally been the preferred therapeutic approach, surgical intervention is becoming more popular, to improve patient outcomes and speed the return to function. Intramedullary screw fixation has developed as a successful surgical treatment for midshaft clavicle fractures, in recent years, giving greater stability and encouraging early mobilisation. This chapter provides an overview of the efficacy, complications, and clinical outcomes of intramedullary screw treatment for midshaft clavicle fractures. According to current research, intra-medullary screw fixation has various advantages over standard nonoperative therapy, including increased fracture stability, lower non-union rates, and improved functional outcomes. Complications from this procedure, such as implant migration or discomfort, are often minor and controllable. However, careful patient selection, preoperative preparation, and surgical expertise are required to achieve the best results.

**Keywords:** midshaft clavicle fracture, intramedullary fixation, common upper limb injury, significantly displaced, shortened
