In this case report we present treatment strategies and the functional and cosmetic outcome in a case of midclavicular fractures. A 20-year-old patient suffered from nearly identical fractures of the left and right clavicle with a time interval of 2 years following snowboard falls. The first fracture was treated conservatively leading to an unsatisfactory course and result. This was the reason why 2 years later the contralateral fracture was treated by intramedullary nailing using an elastic titanium nail. The functional and cosmetic outcome of this treatment was excellent. In cases of clavicular fractures elastic stable intramedullary nailing (ESIN) is a minimally invasive technique leading to fast analgesia resulting in a high level of mobility and ultimately a pleased patient. If the indication is right, intramedullary nailing can be a helpful operation technique which complements the already established procedures (conservative and plate osteosynthesis) in cases of dislocated clavicular fractures.