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These findings suggest that provisional mini-fragment plates do not need to be removed prior to definitive fixation. To report the progression of radiographic healing after intramedullary nailing of tibial shaft fractures using the Radiographic Union Score for Tibial fractures (RUST) and determine the ideal timing of early post-operative radiographs. Retrospective case series. Urban academic Level 1 trauma center. 303 acute tibial shaft fractures underwent intramedullary nailing between 2006-2013, met inclusion criteria, a