Twenty-four ununited, primarily conservatively treated clavicular fractures were treated operatively. The follow-up period averaged 3.5 years. In all cases, the primary displacement was at least equal to the clavicular thickness. The subjective outcome was good in 17 cases, satisfactory in six, and poor in one. In two cases, resection was performed. Our experience of rigid plate fixation and cancellous bone grafting was good with union in 20/22 cases. However, the operations are not uncomplicated and there is a risk of diminished muscle power and range of movement in the shoulder if the clavicle is shortened.