BackgroundIt is often difficult to choose the optimal method for treating the fractures of the lower third tibia due to its closeness to ankle joint, poor blood supply, decrease of the muscles covering the anterior, complications, such as delayed union, nonunion, wound dehiscence, which are usually associated with comminution, severe soft tissue injury. Therefore, the management of the fracture of lower third tibia remains a great challenge to surgeons.Patients and methodsBetween January 2017-January 2020, 96 participants with distal tibial fractures were treated using either MIPO technique or Expert intramedullary nail technique, in a prospective study conducted in Zagazig University Hospitals. 48 participants treated by MIPO technique, 48 participants treated by Expert intramedullary nailing.ResultsThe average age was 45 years, the mean age in gathering A was 46.58±14.9, and in gathering B was 44.83±13.73. The data of Participants were collected in terms of the name, age, sex, occupation, address, special habits, mechanism of injury, associated injury, history of comorbidities e.g. diabetes, hypertension, and peripheral vascular disease. ConclusionDistal tibial fractures often present a challenge to the orthopaedic surgeon. The treatment of this type of fracture is of current research interest, since there is no universally agreed treatment method. The choice of treatment must take into account not only the stabilization of the fracture, but also the management of the soft tissue injury which is a frequent cause of subsequent complications.