75 patients with Robinson type 2B1-2 displaced midshaft clavicle fractures were included in this trial to compare outcomes using a minimally invasive intramedullary nail technique or a standard locking compression plate. Patients were evaluated over a minimum 12-month follow-up period and outcomes included operative time, fluoroscopy time, length of surgical incision, amount of clavicle shortening, length of hospital stay, time to union, disability, function, and cosmetic dissatisfaction. There were no differences in operative time, length of stay, or clavicle shortening between the two groups, however, fluoroscopy time was significantly longer in the intramedullary nail group. Constant scores were similar between groups but Quick DASH was significantly better in the intramedullary nail group, however, this difference did not appear to be clinically relevant. Time to union was significantly shorter and cosmetic dissatisfaction was significantly lower in the intramedullary nail group.