Seventy patients with isolated, closed humeral shaft fractures (HSF) were randomized to operative fixation (n=36) or functional bracing (n=34). The primary outcome was the DASH score at 3 months. Secondary outcomes included EQ-5D/EQ-VAS, SF-12 PCS/MCS, pain, shoulder/elbow ROM, complications, radiographic alignment, and return to work/sport. Outcomes were assessed at 2 and 6 weeks and at 3, 6, and 12 months. Overall, the results revealed better DASH scores with surgery at 6 weeks and 3 months (p=.01 for both), but no differences at 6 or 12 months; surgery also improved early HRQoL and SF-12 MCS to 6 months, with higher return-to-sport rates. Brace-related dermatitis was more common with nonoperative care, and nonunion was numerically higher with bracing. These findings suggest early—but not sustained—advantages of fixation that must be weighed against operative risks.