This is a multicenter, prospective, Post-market Clinical Follow-up (PMCF) Study with retrospective controls.~The study will enroll patients that will be implanted with the Zimmer Natural Nail Bactiguard Tibia device and retrospective controls implanted with standard titanium-alloy tibia nails.~500 tibias will be recruited at maximum 15 sites and allocated on a 1:1 ratio into an:~investigational group (prospective/consecutive series of 250 tibias treated with ZNN Bactiguard tibia)~a control group (retrospective series of 250 tibias treated with uncoated titanium-alloy tibia nail - data collection will be retrospective, these subjects will not have to undergo any study-related procedure).~The primary endpoint is the Fracture Related Infection (FRI) rate in the study population 12 months after fracture fixation.~The secondary endpoint is the confirmation of safety, performance and clinical benefits of ZNN Bactiguard implant and related instrumentation through the following measure systems:~Radiologic (RUST) & clinical (FIX-IT) fracture healing 12 months after fracture fixation (performance).~Patients' outcomes assessed by the Oxford Knee Score 12 months after fracture fixation (clinical benefits).~EQ5D-5L (patients' quality of life).~Incidence and frequency of adverse events (safety).~Data will be collected at 2 weeks, 3 months, 6 months and 1 year after fracture fixation.
Primary objective of this study is to compare fracture related infection (FRI) rates of ZNN Bactiguard Tibia to conventional uncoated titanium-alloy nails 12 months after tibia fracture fixation.~The secondary objectives are confirmation of safety, performance and clinical benefits of ZNN Bactiguard implant and related instrumentation12 months after fracture fixation.