160 patients with a Robinson type 2B1-2 displaced midshaft clavicle fracture were included in this multicenter randomized controlled trial to compare outcomes between operative and nonoperative treatment methods. Patients were evaluated for nonunion, constant shoulder score, disabilities of the arm, shoulder, and hand (DASH) score, pain, secondary operations, and cosmetic result. At one year the rate of nonunion was significantly higher in the nonoperative group as was the rate of secondary plate fixation to manage nonunion. However, there was no difference in the total number of secondary procedures between groups. Additionally, there were no differences in constant and DASH scores between the groups.