Thirty-six patients with Neer type II distal clavicle fractures were randomized to receive surgical fixation of the fracture using a titanium cable and locking plate (n=18) or clavicular hook plate (n=18). Outcomes of interest included incision length, operative time, blood loss, time to fracture healing, pain on a visual analogue scale (VAS), and function via the Constant Murley score. Incision length, operative time, and blood loss were assessed peri-operatively. VAS pain scores were assessed 1 week and 1 year post-operation, and Constant-Murley score was assessed at 1 year post-operation only. Results revealed no statistically significant differences in incision length (p=0.89), blood loss (p=0.68), or fracture healing time {p=0.56) between the two groups. Operative time was, however, statistically significantly longer in the titanium cable group compared to the hook plate group (p<0.001).Furthermore, VAS pain scores at 1 week and 1 year, as well as Constant-Murley scores at 1 year, were statistically significantly in favour of the titanium cable group (p<0.05 for all).Finally, 4 cases of post-operative pain in the shoulder were reported in the hook plate group.