The investigators are comparing two methods of standard treatments in distal tibial fractures. locked plating (M.I.P.O. technique) with intramedullary nailing.

the investigators are hypothesizing that M.I.P.O group is superior to nailing in fractures of the distal third of the tibia.

The kind of plates the investigators are comparing are the Locked plates form Synthes ® using the minimally invasive technique vs the Expert Tibial Nail® from Synthes ®

Inclusion Criteria:

• Males and Females aged from 18-60 years
• Closed Tibia Fracture
• Tibia Fracture Müller AO Class 43-A

Exclusion Criteria:

• Intra-articular Fractures

• Open fractures

• fracturesSubjects with documented Marfan's syndrome or Ehlers-Danlos syndrome or Hajdu-Cheney syndrome.

• Post organ transplant patients (except Cornea transplant)

• Subjects on immunosuppressive medications

• Subjects with diagnosed with

  • Osteogenesis imperfecta
  • Osteopetrosis
  • Paget disease of bone
  • Renal osteodystrophy

• Subjects with diagnosed neoplasms or mitotic illnesses

• Subjects receiving growth hormone

• Unable to comply with postoperative rehabilitation e.g. head injury

• Impending compartment syndrome