Background:Clavicle fractures, accounting for 2.6% of all fractures, are common, especially in active adults and children. The middle third is the most frequent fracture site. Currently, there’s a preference for primary surgical fixation due to unsatisfactory conservative treatment outcomes. Plating has historically been the standard procedure, but intramedullary nailing has emerged over the last decade due to better cosmetic outcomes. Aims and Objectives:To study, compare and evaluate the Radiological and Clinical outcomes of mid-shaft clavicle fractures after surgical fixation using Titanium elastic nailing system (TENS) versus plating. Patient and methods:This study includes 40 patients. They were divided into 2 groups: 20 patients treated with TENS and the other 20 with plating. The study aims to compare the clinical and radiological outcomes of these two treatments. All patients were followed up and assessed at 4 weeks intervals up-to 24 weeks or radiological union, whichever is later.All the diaphyseal non-comminuted clavicle fractures – AO Classification (A1 – A3, B1 – B2) and Fractures with shortening < 2 cm were included in the study. Results: Operative time was much less in TENS(mean 35mins) vs plating(mean47mins) Post-op pain was much less in TENS patients with average VAS score 3.25 on post-op day3 (vs 6.35 for plating). On follow-ups, Constant-Murley scores were found to be better in TENS patients compared to plating. There was no incidence of post operative infection in TENS (20% cases of infection in plating) Conclusion: The study found that TENS procedure has several advantages over the Plating method having shorter operative time, less post-operative pain, faster return to normal shoulder function, less risk of infection and smaller surgical scar. In the long run follow-up (after 16weeks) both TENS and plating produce similar functional outcome