Open Reduction and Internal Fixation (ORIF) of the clavicle is a surgical procedure used to treat a broken collarbone when the fracture is significantly displaced, shortened, unstable, or unlikely to heal well with a sling alone. It is most commonly recommended for mid-shaft clavicle fractures where the bone ends have shifted, overlapped, or pierced surrounding tissue, or when proper shoulder function is at risk. Before surgery, the patient undergoes a clinical evaluation and imaging studies such as X-rays or, in some cases, CT scans to assess the fracture pattern and alignment. The care team reviews overall health, medications, and activity needs, especially for patients who rely heavily on shoulder strength for work or sports. Temporary immobilization in a sling is typically used while surgery is being scheduled. The procedure is performed under general anesthesia. During surgery, the surgeon makes an incision over the clavicle to directly access the fracture site. This allows precise realignment of the broken bone fragments, known as open reduction. Once the clavicle is restored to its normal length and shape, internal fixation is performed using a contoured metal plate and screws placed along the bone. This hardware stabilizes the fracture, maintains alignment, and allows the bone to heal in the correct position. After surgery, patients usually go home the same day or after a short hospital stay. The shoulder is supported in a sling to protect the repair and limit movement during early healing. Pain, swelling, and bruising around the shoulder and chest are common initially and are managed with medications and activity modification. Recovery is gradual and structured. In the early weeks, patients focus on protecting the repair while performing gentle movements to prevent stiffness. As healing progresses, physical therapy is introduced to restore shoulder range of motion, followed by strengthening exercises. Lifting, overhead activity, and contact sports are restricted until imaging confirms solid bone healing. Most clavicle fractures heal over several months. ORIF can lead to faster functional recovery, improved shoulder strength, and a lower risk of bone malalignment compared to non-surgical treatment in appropriately selected patients. In some cases, hardware may remain permanently unless it causes irritation and requires later removal.