Minimally invasive plate osteosynthesis (MIPPO) of the distal tibia offers several advantages compared to classic open reduction and internal fixation. Minimally invasive percutaneous plating osteosynthesis (MIPPO) technique in fractures of distal tibia provides mechanically stable fracture-bridging osteosynthesis thereby preventing damage to bone vascularity, reduce iatrogenic soft tissue injury and preserve the fracture hematoma as compared to classic open reduction and internal plate fixation. Minimally invasive osteosynthesis offers the best possible option as it permits adequate fixation in a biological manner. A series of 25 patients treated for distal tibial fractures using a distal tibial locking plate through the MIPPO technique have been reviewed after surgery. There were 16 males and 9 females of mean age 48.5 years. The commonest cause of injury was road traffic accident. Minimally invasive plate osteosynthesis is a good and safe technique for treatment of distal tibial fractures injuries when there is no articular comminution and the soft tissue envelope is minimally disturbed.
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