25 patients were randomized to receive either minimally invasive plate osteosynthesis (MIPO) or intramedullary nailing (IMN) for an extra-articular distal tibial fracture. The purpose of the study was to compare the two treatment methods and assess whether one was superior to the other in treating extra-articular distal tibial fractures. The results of this study showed similarity in functional and alignment outcomes, with the exception of lower clinical rotation in the MIPO group. Additionally, MIPO also demonstrated favourable intraoperative factors, such as incision length and blood loss.