PURPOSE: To evaluate the efficacy of the surgical treatment through the comparison of MIPPO vs open plate fixation in the treatment of the distal tibia fracture retrospectively. MATERIALS AND METHODS: 30 patients with distal tibia fracture from Jun. 2001 to Jun. 2004 were divided into two groups depending on the surgical method. Minimum follow up was 12 months. Group A consisted of 15 patients treated with MIPPO, Group B was 15 patients treated with open plate fixation. The clinical outcomes were evaluated retrospectively from operation time, rehabilitation, ROM, interval change of postoperative CRP to assess postoperative inflammatory reaction, postoperative complications and clinical result with the use of McLennan and Ungersma criteria. RESULTS: There were no significant differences in clinical result by McLennan and Ungersma criteria in both groups. The postoperative 3 days and 7 days CRP were 4.0mg% (0.9~7.2)/0.5 mg% (0.1~1.5) in group A and 7.97mg% (2.8~14.6)/1.0mg% (0.3~1.6) in group B, shows more minimal tissue injury and early recovery in group A. Operation time in group A was shorter than group B. Normal recovery of ROM was quicker in Group A. In complications, group A showed one superficial infection and one angular deformity and group B showed one superficial infection, one infected nonunion and two ankle stiffness. CONCLUSION: There were no significant differences in clinical result and bony union. MIPPO technique is superior to group B in view of the minimal tissue injury, complications, operation time and postoperative rehabilitation.