We reviewed the early clinical results of 4 distal tibial fractures using the minimally invasion plate osteosynthesis (MIPO) technique. The average age of the patients was 67.7 years. The mean follow-up period was 3.9 months. All fractures were extraarticular fracture of the distal tibia, and mean operating time was 54 minutes. Time to full weight-bearing was 7 to 8 weeks. Though the minimally invasive technique for plate osteosynthesis in the treatment of diatal tibial fracture is considered useful, the indicaton for using this technique must be evaluated carefully. The MIPO technique is considered a better choice for patients with severe general conditions, and fractures with little displacement.