Purposes We evaluated the usefulness of minimally invasive plating in patients with fresh midshaft clavicular fractures.Methods Between September 2007 and February 2010, 69 patients with an average age of 38.6 (range 19-68) years were operated on for midshaft clavicular fractures with universal reconstruction ribbon plate (URRP) in a minimally invasive way.According to the Robinson classification, 49 fractures were type 2B1 and 20 were type 2B2.Miscellaneous accidents were involved in 34 patients (49%).Concomitant injuries were involved in 22 patients (32%).The mean follow-up time was 30.6 months (range 16-43 months).Results All patients achieved bony union with an average time of 14.6 weeks (range 8-46 weeks) but two delayed unions developed.There were two seroma, one plate breakage, two patients with lateral screw pullouts and five patients complained of mild irritation over the implant during shoulder motion.Thirty-seven patients (54%) had hardware removal.At the last follow-up, the mean Constant-Murley score was 92 (66-100) points, and the mean DASH score was 4.6 (0-23) points.A total of 64 (93%) patients were satisfied with the operation for clavicular fractures.Conclusions The preliminary results demonstrate that our method can provide quick pain relief, high union rate, and good cosmetic and functional results.This method can be considered as an alternative to standard plate osteosynthesis or intramedullary fixation method for fresh displaced midshaft clavicular fractures.