Limb Injuries and Post Injury Rehabilitation Trials - Tibial Shaft Fracture

Inclusion Criteria: * AO/OTA 42-A/B acute, noncomminuted diaphyseal fracture of the tibia treated with intramedullary nailing with or without posterior malleolus screw fixation * operated within 72 hours of admittance * age between 18-65 years Exclusion Criteria: * the inability to fill out the Finnish versions of the questionnaires * previous arthroplasty of the knee or the ankle of the fractured limb * previous ipsilateral below-knee fracture requiring surgical treatment or ankle arthrodesis * inability to co-operate * not living independently (institutionalized living before fracture) * open fracture (Gustilo grade 2 or over) * pathologic or stress fracture * multiple fractures requiring operative treatment in polytrauma patient * severe medical comorbidity impairing daily activities (inability to go climb three floors without assistance and stopping) * Body Mass Index over 40 * unacceptably high risk of surgery due to severe medical comorbidities * severe substance abuse * patient is retired * age is less than 18 or more than 65 * patient required a fasciotomy due to acute compartment syndrome during or after index surgery * inability to walk before fracture or a daily need of walking aid, such as crutches