Background: Of all clavicle fractures midshaft fracture accounts for 80-85%.These are generally managed conservatively.Indication for surgery are imminent perforation of skin or existing neurovascular compromise,floating shoulder and gross displacement of fracture fragments.Early functional recovery and a rapid return to daily activities and low complication rate have been reported as advantages of clavicle fracture fixed with TENS. Aim and objectives: To study the cause of failure to achieve reduction by closed methods and to correlate with available classification of clavicle fracture. Design: A retrospective study. Materials and methods: Over a decade 487 patients in Soundarapandian Bone and Joint Hospital and Research institute were operated during the study period of 2013 to 2023.Fracture classified using Robinson classification. Inclusion criteria: Midshaft, segmental type fracture. Exclusion criteria: Medial and lateral end clavicle fracture. Result: Most cases were operated within 24-48 hours after trauma. Out of 487 cases, closed reduction and nailing was done in 383 cases, while in 104 cases, open reduction and nailing was needed. Open reduction was necessary in Robinson type B1 and B2 fractures. Discussion: This study evaluates the radiological parameters used to determine the need for open reduction in mid shaft clavicle fracture and helps the surgeon to decide prior to surgery which fracture configuration requires open reduction.