The anterior-inferior clavicle plate position will have a lower rate of soft tissue irritation that limits activity and/or requires hardware removal compared to superior plate position.

Compare the rates of soft-tissue irritation with two different methods of plating for clavicle fractures. Patients will be randomized to anterior-inferior or superior plating. Validated shoulder scoring systems will be used to assess outcome. Specific follow-up questions will address the patient's ability to wear his/her uniform, body armor, ruck sack, and other shoulder-borne equipment over the surgical site.

Inclusion Criteria:

• Active duty, Reservists, National Guard service members
• completely displaced shaft fracture of the clavicle (no cortical contact between the main proximal and distal fragments)
• a fracture involving the middle third of the clavicle (a fracture amenable to plate fixation with a minimum of three screws in each proximal and distal fragment)
• chronic nonunion and malunion fractures
• no medical contraindications to general anesthesia
• provided informed consent.

Exclusion Criteria:

• an age of less than eighteen years or greater than sixty five years
• a fracture in the proximal or distal third of the clavicle not amenable to plating
• a pathological fracture
• an associated head injury (a Glasgow Coma Scale score of <15 at 21 days after injury)
• an inability to comply with followup
• a medical contraindication to surgery and/or anesthesia (such as heart disease, renal failure, or active chemotherapy)
• a lack of consent.