72 patients with clavicular shaft fractures were randomized to receive an open reduction and internal fixation procedure utilizing either a anatomically contoured locking plate or an intramedullary nail. The primary outcomes of interest included DASH scores, Constant Shoulder scores, and union rate. Secondary outcomes included operative time, incision length and the rate of hardware failure. Follow up was performed at 6 weeks, 3 months, 6 months and 12 months. DASH scores were significantly in favour of the intramedullary nail group at 12 months; no significant differences between groups were observed in DASH scores up to 6 months. No significant differences were observed between the two groups in Constant Shoulder scores or the rate of union. Operative time and incision length were both significantly longer in the locking plate group compared to the intramedullary nail group. Both groups displayed 1 event of hardware failure.