Distal tibial fractures are very commonly encountered by orthopaedic surgeons. Fractures of distal tibia are among the most perplexing injuries. Distal tibial fractures are difficult to manage due to its poor blood supply and limited soft tissue. Soft tissue injury component is a major concern among these fractures and may result in serious complications and disability 
. High energy motor vehicle accidents are the common cause 
. 0.7% is the incidence of distal tibia fractures and it accounts to about 10-13% of all tibial fractures 
. The aim of this study was to evaluate the functional outcome and to study major complications in KIM’s hospital.
Materials and Methods: A prospective study which was carried out from October 2015 to September 2017 in Karnataka Institute of Medical Sciences, Hubbali, and Karnataka State, India. In this study period, cases of distal tibial fractures were treated by open reduction and internal fixation using MIPPO. All patients with age >18 years, closed fractures without intra-articular extension and Gustillo type 1 fractures were included. Pathological fractures and grade 2 and above were excluded.
Results: In our series of 18 cases, there were 14 men and 4 women, with average age of 40.3 years. Sixteen (88.8%) cases were admitted due to RTA and with slight predominance of left side. All fractures healed with good functional outcome. Mean union time was 22.6 weeks. 14 cases showed good ankle function outcome and 3 showed fair ankle function outcome according to Merchant and Dietz criteria. There was 1 case of superficial infection, treated successfully with antibiotics.
Conclusion: The strategy of biological osteosynthesis with a bridge plating is less invasive, with fewer soft tissue impingement and improved cosmoses and convenient for removal.