Five randomized controlled trials were included in this meta-analysis investigating the comparative efficacy between intramedullary fixation and plate fixation in operative management of midshaft clavicle fractures. Results from meta-analyses significantly favoured intramedullary fixation over plate fixation for operative duration, incision length, time to union, and Constant score function. The rate of certain complications were also lower with intramedullary fixation (superficial infection, symptomatic hardware, hypertrophic scarring), though there were no differences observed for incidences of implant failure, nonunion, or refracture.