174 patients with an acute displaced mid-shaft fracture of the clavicle were randomized to either nonoperative management with sling immobilization, or surgical intervention with a precontoured plate and locking screws. The study was conducted in order to compare fracture healing, shoulder function, and time lost to sick leave between operative and nonoperative treatment over 1 year follow-up. Results demonstrated a significantly reduced non-union rate and sick leave duration with operative versus nonoperative treatment. Short-term (3-month) functional outcomes also favoured operative treatment compared to nonoperative treatment, though differences in functional outcome between groups at 1 year post-treatment were not significant.