Introduction: Distal tibial fractures are one of the perplexing injuries encountered due to their poor blood supply and limited soft tissue cover. We aim to study and compare clinical and radiological outcomes in extra-articular fractures of the distal tibia treated with intramedullary interlocking nail (IMILN) and Minimally Invasive Plate Osteosynthesis (MIPO) locking compression plates.

Methods: The study included 7 women and 17 men. 12 patients underwent MIPO, and 12 patients underwent CRIF with an IMIL nail. Postoperative outcomes were evaluated using the Johner & Wruhs criteria for up to 12 months, focusing on fracture union, malunion, infection, range of motion, pain, and gait abnormalities.

Results: The age of the patients ranged from 18 to 70 years. Road traffic accident was the major cause in both groups. Mean surgical time was 59.6 (± 8.9 SD) minutes in the MIPO group and 57.1 (±7.5 SD) minutes in the IMILN group. The mean full weight-bearing period was 20.6 (±1.5 SD) weeks in the MIPO group and 18.2 (±2.2 SD) weeks in the IMILN group, while the mean union time in MIPO was 21.0 ± 1.9 weeks and 17.92±2.31 weeks. 3 cases in MIPO had ankle stiffness, and 4 cases in IMILN developed knee pain.

Conclusion: The study concluded that both MIPO with a medial distal tibial locking plate and closed IMILN are viable options for managing extra-articular fractures of the distal tibia. The choice depends on patient and fracture characteristics.

Keywords: Distal Tibia Fracture; Interlocking Nailing; MIPO Locking Plate