64 patients with clavicle midshaft fractures were randomized to receive treatment with the minimally invasive percutaneous plate osteosynthesis (MIPPO) technique or conventional open reduction with locking compression plate (LCP). Over a mean follow up of 15 months, the MIPPO group reported greater satisfaction with the cosmetic appearance and with the overall outcome. There was also a lower rate of dysesthesia and hypertrophic scarring in the MIPPO group. However, there was no difference between the two groups for the mean time to union, Constant shoulder scores, and Disability of the arm, shoulder and hand (DASH) scores.