Objective: To compare the clinical efficacy of Nice knot-assisted locking compression plate internal fixation versus traditional locking compression plate internal fixation in the treatment of comminuted clavicle fractures (Allman type Ic / Robinson type 2B). Methods: Clinical data of 60 patients with comminuted clavicle fractures admitted to Ji"an First People"s Hospital from January 2023 to December 2025 were retrospectively collected. Patients were divided into the Nice knot group (Nice knot-assisted locking plate internal fixation, n=30) and the control group (traditional locking plate internal fixation, n=30) according to the surgical method. Operative time, intraoperative blood loss, fracture healing time, postoperative Visual Analogue Scale (VAS) score, Constant-Murley shoulder function score, and complication rate were compared between the two groups. Results: The operative time was shorter (P<0.05) and intraoperative blood loss was less (P<0.05) in the Nice knot group compared with the control group. VAS scores on postoperative days 3, 7, and 10 were lower (P<0.05), and Constant-Murley scores were higher (P<0.05) in the Nice knot group than in the control group. There was no statistically significant difference in fracture healing time between the two groups (P>0.05). The complication rate was lower in the Nice knot group than in the control group (P<0.05). Conclusion: Nice knot-assisted internal fixation for the treatment of comminuted clavicle fractures can shorten operative time, reduce intraoperative blood loss and periosteal stripping, alleviate postoperative pain, promote early fracture healing, and facilitate early recovery of shoulder joint function, thus meriting clinical promotion.