The primary purpose of this study is to perform a high-quality randomized control trial comparing intramedullary tibial nail fixation with standard design nails to a micromotion tibial nail device, to evaluate the rates of union and post-operative outcomes.

Inclusion Criteria:

• Age 18 - 85 years
• Stable Tibial fracture recommended for surgical intervention

Exclusion Criteria:

• Patients not meeting inclusion criteria
• Unstable fracture patterns e.g. those needing a secondary intervention - masquelet/cement spacer)
• Previously non-ambulatory patients
• Delayed presentation of fracture (>4 weeks)
• Fractures that the treating surgeon indicates requires additional fixation strategies to achieve stability
• Patients with an achieve infection or wound at the surgical site
• Any previous ligament or fracture surgery on the index site
• Inflammatory rheumatic disease or other rheumatic disease-
• Immune compromised patients (hepatitis, HIV, etc.)
• Unwilling or unable to participate or follow study protocol