120 patients with a displaced midshaft clavicle fracture were randomized to fixation with either an intramedullary nail or a plate. Patients were assessed for disability, incidence of implant-related irritation, and incidence of removal due to implant-related irritation. Results on the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score demonstrated no significant difference between groups at 39 months. The overall incidence of implant-related irritation did not significantly differ between groups. The incidence of implant removal due to irritation was 35/62 in the nail group and 21/56 in the plate group.