Seventy patients with isolated, closed humeral shaft fractures were randomized to receive either open reduction and plate fixation (n=36) or functional bracing (n=34). The primary outcome of interest was the DASH score at three months. Secondary outcomes included health-related quality of life (HRQoL), pain scores, shoulder/elbow range of motion, complications, and return to activity over one year. Overall, the results revealed that surgery led to superior functional outcomes at three months (mean DASH 24.5 vs. 39.4; MD 15.0, p=0.006) and improved HRQoL and pain scores over the first six months. Surgery also resulted in better shoulder and elbow mobility and a higher rate of return to sport. However, by one year, there were no significant differences between groups. These findings suggest that while surgery provides early functional benefits, the long-term outcomes are similar between treatment approaches.