Objective To evaluate the efficacy of minimally invasive percutaneous plate osteosynthesis(MIPPO) for the treatment of tibial fracture. Methods From August 2005 to January 2007,a total of 26 patients with tibial fracture were treated with MIPPO in our hospital.Among the patients,the facture was located at the proximal tibia in 8,the distal tibia in 7,and the shaft in 11.Results The incision size was 4.0-8.5 cm with a mean of 6.6 cm;the intraoperative blood loss ranged from 80 to 400 ml(mean,180 ml);and the operation lasted 40-120 minutes(mean,87 minutes).The swelling subsided 1-6 days after the operation(mean,2.5 days).All the incisions healed primarily.The patients were followed up for 6 month on average(3 to 15 months).The fractures healed in 3-13 months(mean,4.2) after the operation.No complications,including delayed incision healing,incision infection,parenchymal necrosis,bone exposure,delayed union,and non-union,occurred in the series.According to the Johner-Wruhs criteria,the knee and ankle functions were excellent in 19 patients,good in 4,fair in 2,and poor in 1.Conclusions The MIPPO provides biological fixation and results in minimal parenchymal injury in patients with tibial fracture.By using the technique,the patients recover quickly with few complications and mild reaction to the trauma.The method is an optimal approach that is worth being promoted.