Abstract： Objective To summarize the surgical experiences and clinical response of minimally invasive plate osteosynthesis(MIPO) in the treatment of length segment fracture with distal tibial. Methods From January 2005 to January 2008, 25 patients with length segment fracture with distal tibial were treated by MIPO in our department. According to the AO classification, there were 5 cases of type A, 8 type B, 12 type C. All cases were checked by radiographs and clinical examinations, and evaluated by knee Rasmussen scores. Results All patients were consecutive followed up till bone healing. No union, no reduction of plates and screws, no superficial wound infection and seromas occurred except 1 patient with 7° Valgus deformity and 1 patient with 10°. Conclusions Minimally invasive plate osteosynthesis can be used successfully to treat complex distal of tibial fracture without the need for additional medial stabilization. The MIPO provides stable fixation, high rate of union and low rate of infection of distal tibial fracture.