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