The tibia is one of the long bones of the lower limb and lies medial to the fibula. Tibial fractures are one of the most frequent long-bone fractures encountered. They usually occur due to high energy trauma like motor vehicle accidents, sports or falls from height. The patient's medical history should be reviewed because of systemic problems. Patient characteristics, such as smoking, alcoholism, peripheral vascular disease, diabetes and metabolic bone disease may affect treatment planning. The initial radiographic evaluation of all fractures of the tibial diaphysis should involve antero-posterior (AP) and lateral radiographs. Distal tibia fracture management is difficult due to wound infections and poor wound healing caused by unstable blood supply. Different surgical procedures, including closed intramedullary nailing, open reduction, internal fixation with conventional plate osteosynthesis, and external fixation, have been tried. There are benefits and drawbacks to each type of treatment. The goal of surgical management for distal tibia fracture is anatomical reduction with stability, prevention of deformity and early mobilization. Conservative management may play a role in stable and non-displaced fractures or in displaced fractures if they are patients with a high surgical risk. Tibial diaphyseal fractures and distal extra-articular fractures are treated with intramedullary nailing; however, distal fractures that are close to the joint or extend into the joint surface should not be treated in this way. External fixation Used either for temporary stabilization or for definitive fixation, is indicated in some cases as extensive comminution of both articular and periarticular fractures. Conventional open reduction and internal fixation (ORIF) has better fracture reduction, better fixation and early mobilization, but needs extensive soft tissue dissection and also has higher rate of complications like infection, delayed union due to drainage of fracture hematoma, non-union and big scar marks. To minimize disruption of soft-tissue envelope and periosteal blood supply. Minimal invasive precutaneous plate osteosynthesis (MIPPO) was developed to maintain a more biologically favourable environment for fracture healing. Historically, tibial pilon fractures were managed by antero-medial approach but one of the major disadvantages in taking this approach is the risk of wound breakdown with exposure of the implant. Implant prominence with antero-medial plating has modulated implant removal as a revision surgery. Antero-lateral area of distal tibia has shown better soft tissue coverage along with a better direct exposure to the antero-lateral fragment