120 patients with displaced midshaft clavicle fracture were randomized to receive either surgical plate fixation or intramedullary fixation. The purpose of this study was to compare the results of plate and intramedually fixation via the Surgical Therapeutic Index, a tool in which the success rate of treatment is divided by the observed complication rate. In the application of the Surgical Therapeutic Index, as the higher the value, the greater the benefit versus risk considered for the intervention. Weighted and nonweighted analyses of the Surgical Therapeutic Index were performed to account for complication severity. Results demonstrated significantly higher Surgical Therapeutic Index for plate fixation compared to intramedullary fixation at 6 weeks in both weighted and nonweighted analyses, as well as 6 months in the weight analysis, exclusively. At 12 months postoperatively, no significant difference between groups in Surgical Therapeutic Index was observed.