132 patients with a displaced midshaft clavicle fracture were randomized to undergo either nonoperative or operative plate fixation to compare functional and patient-oriented outcomes between these treatments. Results at 6 weeks and at 3, 6, and 12 months displayed better Constant and DASH score results for patients who underwent operative care. Patients were also more satisfied with the function and appearance of their shoulder after plate fixation. The operative treatment produced a lower rate of malunion and nonunion compared to the nonoperative treatment.