Criteria-Based Rehabilitation After Tibial Fracture Fixation: A Randomized Controlled Trial

Inclusion criteria: * Age ≥18 years. * Traumatic unilateral tibial fracture involving the proximal tibia/tibial plateau, tibial shaft, or distal tibia. * Treated with surgical fixation. * Recruitment 2-8 weeks after the index fixation surgery. * Medically and surgically stable and cleared by the treating team to participate in physiotherapy. * Documented postoperative weight-bearing status/instructions from the treating orthopedic team. * Able to participate in the study rehabilitation and complete the planned functional assessments when permitted by weight-bearing status. * Able to understand study instructions and provide written informed consent. * Open fractures are eligible provided the wound is clinically stable, there is no active uncontrolled infection preventing rehabilitation, and rehabilitation has been authorized by the treating surgical team. Exclusion criteria: * Pathological fracture. * Unstable fixation, fixation failure, or any orthopedic/medical contraindication to progressive rehabilitation. * Active or uncontrolled infection requiring restriction or interruption of rehabilitation. * Lower-limb amputation affecting functional assessment. * Spinal cord injury or severe traumatic brain injury affecting mobility or ability to participate. * Pre-existing neurological disorder substantially affecting gait or lower-limb function. * Major concomitant injury to either lower limb that substantially limits walking or participation in the rehabilitation protocol. * Severe cognitive impairment preventing understanding of instructions, valid outcome assessment, or informed consent. * Any medical condition considered by the treating physician to make participation in the rehabilitation program unsafe.