[Objective] To compare the clinical efficacy of the bridge-link fixation combined with Nice knot (BLFNK) versus plate for midshaft clavicular fractures. [Methods] A retrospective study was conducted on 62 patients who received open reduction and internal fixa- tion (ORIF) for midshaft clavicle fractures in our departments from January 2019 to June 2021. According to the results of doctor-patient communication, 28 patients were treated with BLFNK, while the remaining 34 patients had fractures fixed with plate. The documents re- garding to perioperative period, follow-up and imaging were compared between the two groups. [Results] All the patients in both groups had ORIF performed smoothly with no serious complications such as vascular and nerve injury. The BLFNK group proved significantly su- perior to the plate group in terms of operation time, intraoperative blood loss and time to return active activity (P＜0.05), although there were no significant differences in incision length, incision healing grade and hospital stay between the two groups (P＞0.05). The VAS scores for pain during the early postoperative period were significantly reduced over time in both groups (P＜0.05), which was not significantly differ- ent between the two groups at corresponding time points (P＞0.05). All of them in both groups were followed up for more than 12 months, and the BLFNK group resumed full weight-bearing activity significantly earlier than the plate group (P＜0.05). The Constant-Murley scores significantly increased in both groups over time after surgery (P＜0.05), which was not significantly different between the two groups at corre- sponding time points (P＞0.05). Radiographically, the BLFNK group got better fracture reduction quality than the plate group regardless of the fact that there was no statistical difference between the two groups (P＞0.05). In addition, there was no significant difference in fracture healing time between the two groups (P＞0.05). [Conclusion] The bridge-link fixation system combined with Nice knot achieves better clini- cal outcomes than the traditional plate internal fixation for midshaft clavicle fractures.