Objective To evaluate the therapeutic effect of incisional resorption resorbable rib nailing in the treatment of completely misaligned middle clavicle fractures in older children. Methods From January 2007 to the present, six cases of completely misaligned middle clavicle fractures in older children were treated with incisional repositioning resorbable rib nail fixation, all of them were middle clavicle fractures, with the age range of 10 to 16 years old and the average age of 13 years old. An anterior approach to the clavicle was used for incisional repositioning and resorbable rib nail fixation. Postoperative triangular scarf suspension was used for 4 weeks. All 6 cases were followed up for 6 months to 2 years and 2 months, with an average of 10 months. 6 children healed with an average healing time of 4 weeks and good function. There were no complications such as delayed fracture healing, nonunion, subcutaneous fluid accumulation, or postoperative fracture re-displacement. Conclusion The incisional resorption resorbable rib nail has good clinical application value in treating completely misaligned middle clavicle fractures in older children, no adverse human reactions, can spare patients from secondary surgical pain, and has satisfactory efficacy, which is a better method for treating middle clavicle fractures in older children.