The traditional approach to the treatment of displaced clavicle fractures does not generally advocate incisional internal fixation. However, there are many clinical reasons that compel orthopaedic surgeons to consider performing surgery: the patient’s requirement for accurate repositioning, the reliability and uncomfortable forced position of traditional external fixation methods, the long treatment time, the potential threat of the mobile fracture end to important nerves and blood vessels, and so on. For the above situation, since 1995, we have treated displaced clavicle fractures in young adults and some elderly and children with multiple ways of internal fixation by incisional reduction, and compared the advantages and disadvantages of various surgical methods, which are reviewed as follows: 1. Small incisional reduction, internal fixation with a distal retrograde needle through a Kirschner pin, and subcutaneous embedding of the needle tail method The patient is placed in a flat position with a pillow under the affected shoulder. A small subclavian incision of about 2-3 cm is made at the fracture end to expose the distal fracture end, and a homemade sigmoid hook (bent Kirschner needle) is used to poke into the medullary cavity, hook out the distal fracture end, drill a suitable Kirschner needle retrograde, penetrate the skin from the posterior side of the shoulder crest end, wait until its end recedes to the distal end far from the fracture, hook out the proximal fracture end with a sigmoid hook, lift the two fracture ends forward to reset with a gauze strip, and then drill the Kirschner needle medially and retrograde into the proximal end 4-5 cm. Then the tail of the needle was cut, bent and buried under the skin. This method for our early surgical methods, because the postoperative Kirschner needle easily displaced outward, top in the subcutaneous or even do out of the skin, resulting in processing difficulties, is now rarely used. 2, the distal retrograde needle through the extra-skin needle method The method is the same as above, but the tail of the needle will be bent and hooked and left outside the skin, so as to avoid discomfort caused by the postoperative Kirschner’s needle on the subcutaneous, the same principle of care and bone traction. This method still can not prevent the internal fixation needle outward displacement, now rarely used. 3, the proximal retrograde needle subcutaneous buried needle tail method This is a better method preferred in recent years, can be used as the first choice for internal fixation of the clavicle. The specific method is: after exposing the distal and proximal ends, the proximal end of the fracture is hooked out first, and the Kirschner needle is drilled retrograde inward, and the anterior cortical and skin of the clavicle is pierced out, and the Kirschner needle is drilled into the distal end after resetting, and the tail of the needle is cut short and bent and buried under the skin. 4.Plate screw internal fixation In recent years, according to the principle of AO internal fixation technology, we have adopted incisional repositioning plate screw internal fixation for some cases and received better results. Because of shortening the treatment and leave cycle, it is well received by many young and strong patients. However, compared with the 3rd method, the incision is larger and some young women cannot accept it.