This study was performed to assess and compare the functional outcomes of fractures in Group A (treated with MIPO plating) versus Group B (treated with intramedullary nailing) and To assess the complications of both procedures.  Methods A total of 40 patients will be taken for study as per inclusion criteria. The patients will be divided into two groups 20 cases each. Group A will be treated with MIPO plating and group B will be treated with intramedullary nailing. Pre-operatively anteroposterior and lateral radiographs were obtained in all cases and computed tomography scans in patients with the most complexfractures to rule out intra articular extension. Follow-up evaluations were carried out at 3, 6, and 12 weeks and 3 and 9 months postoperatively, using Olerud and Molander functional score.  Results This study shown that IMILN has better outcome as it offers advantage in terms of mean operating time, less invasive surgery, hospital stay, partial & full weightbearing time and union time. In osteosynthesis of displaced extra-articular lower tibia meta-diaphyseal fractures OTA/AO Type 42A- C (distal) & 43-A both modalities nailing as well as plating deserve a place.

Keywords : Distal Tibial Fractures, Minimally Invasive Plate Osteosynthesis (MIPO), IMIL (Intra Medullary Interlocking) Nail, Olerud and Molander Functional Score.