All adults (18 years and over) with diaphyseal fractures of the tibia who present to a recruiting hospital during the study period will be eligible to enrol into the study. The AO classification 42 will be used to define tibial shaft fractures. Any fracture that extends into the articular surface will be excluded. From an analysis of previous Liverpool patients and the literature, the investigators expect that this population will be 75% - 85% male with an average age of 30-35 years old. There will be no upper limit to ages. If a participant has sustained bilateral tibial shaft fractures, each will be enrolled separately, left before right.