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Ojeetive: The aim of this study was to compare the results of closed or open reduction and ETN(Expert Tibial Nail) nailing(group A) with closed reduction and minimally invasive plating(group B).Methods: 34 matched cases has been divided into two groups (group A and group B) with regard to age, soft tissue condition, and the AO classification of the fracture and had been treated with either method.Then these patients were followed up and the results were retrospectively analyzed.Results: The group A was follow up for a mean of 24 months versus group B for a mean of 26 months.Three patients in group A versus one patients in group B had a malalignment (>5°).Patients in group A had a short operating time, hospital stay and early full weight-bearing (FWB).There was no difference with regard to time to union or non-union, limb shortening, hardware failure, functional score and infections between two groups.Conclusion: Both treatment methods achieved satisfactory functional outcomes in patients with distal metadiaphyseal tibial fractures.ETN showed advantages in term of operation time, hospital stay and early full weight-bearing; however, closed reduction and minimally invasive plating often resulted in better alignment.ETN are recommended for fractures associated with open injury that had a poor soft-tissue condition.