Objective To compare the clinical effects of minimally invasive percutaneous plate osteosyn-thesis(MIPPO)and interlocking intramedullary nail(IMN)internal fixation in the treatment of segmental tibial shaft fractures.Methods A total of 41 patients with segmental tibial shaft fractures in the Affiliated People's Hospital of Jiangsu University and Northern Jiangsu People's Hospital were selected as the study subjects,including 22 cases in the MIPPO group and 19 cases in the IMN group.All patients were followed up for 1 year.The clinical data such as the intraoperative bleeding volume,total blood loss volume(the difference value of hemoglobin before operation and on postoperative 1 d),postoperative early loading time,fracture healing time,incidence rate of postoperative complications and Johner Wruhs functional score in postoperative 1 year were compared between the two groups.Results Compared with the MIPPO group,the fracture heal-ing time in the IMN group was shorter[(17.39±2.10)weeks vs.(19.34±3.22)weeks,P＜0.05)],postoper-ative loading time was early[(6.93±1.04)weeks vs.(8.71±1.38)weeks,P＜0.05],total blood loss volume was greater[(32.89±6.55)g/L vs.(18.36±4.27)g/L,P=0.177)],but the intraoperative average blood loss had no statistical difference between the two groups[(99.33±31.62)mL vs.(87.34±24.15)mL,P=0.177].There was 1 case of malunion with a forward angle of 8° in the IMN group,1 case of infection,and the incidence rate of complications was 10.53％.In the MIPPO group,there were 3 cases of bone nonunion,2 ca-ses of infection and the incidence rate of complications was 22.73％.The complication incidence rate and the excellent and good rate of Johner Wruhs functional score in postoperative 1 year had no statistical difference between the two groups.Conclusion IMN could provide the stronger fixation,shorter fracture healing time,and early weight bearing functional exercise,which is the better choice for treatment of segmental tibial frac-tures.