Ipsilateral fractures of the scapular neck and clavicle disrupt the suspensory mechanism of the shoulder, resulting in functional loss and deformity. Fifteen patients who had such fractures were managed with open reduction and internal fixation and were followed for an average of twenty-five months (range, fourteen to forty-seven months). All but one patient had a good or excellent functional result according to the scoring system of Rowe. All fractures healed at an average of eight weeks postoperatively. Complications from concomitant fractures of the ribs were treated uneventfully. We concluded that operative treatment of these complex fractures is safe and yields predictably good results.