59 patients with midshaft clavicular fractures were randomly assigned to receive either reconstruction plate fixation or elastic stable intramedullary nailing (ESIN) fixation. This trial aimed to compare the clinical, functional, and radiographic outcomes of both treatment methods up to 12 months postoperatively. The findings indicated that plate fixation and ESIN fixation were comparable across all outcomes, and the risk of major complications was minimal in both groups. However, patients who underwent plate fixation experienced implant bending, while patients who underwent ESIN experienced hardware-related pain.