39 yr old diabetic female presented to us with comminuted fracture tibia distal 1/3^rd region with segmental fracture fibula. The patient was diabetic with poorly controlled blood sugar levels. The patient was also obese. At time of presentation, there was moderate swelling in leg with overlying skin slightly shiny. There was poor pulse in peripheral vessels of both ankles, implying some underlying compromise on distal blood flow, in both limbs.  The fracture was fixed using a distal medial tibia plate with locking screws. This implant was inserted using minimally invasive percutaneous osteosynthesis (MIPO) technique. The advantages of this technique, particularly in this patient were use of short surgical incisions, short operative time, minimal stripping of periosteum from bone ends and very less blood loss. The reduction achieved was anatomical. There was very good and rapid healing of the wounds. The limb was maintained in plaster for 2 weeks and then ankle mobilization was started.