Abstract: Objective：To investigate the application effect of doublereverse traction reset and fixation with MiPPO for patients with comminuted fractures of middle and distal tibia.Methods：84 patients with comminuted fractures of middle and distal tibia were randomly divided into observation group and control group, with 42 cases in each group. Both groups underwent MIPPO,the observation group was treated with doublereverse traction reset and fixation,the control group was treated with conventional reset and fixation. The perioperative conditions were compared between the two groups,the eduction of fracture,the lower extremity function, ankle function and fracture displacement parameters were evaluated.Results：The operation time, intraoperative blood loss,limited incision rate , postoperative weightbearing time and fracture healing time were significantly lower than the control group(P<0.05),the reduction effect of the observation group was better than that of the control group (P<0.05).The length of the distal movement and distal segment, the inner and outer angle,left and right offset of the proximal ring, and the offset of the proximal ring were significantly reduction (P<0.05), which were better than the control group(P<0.05). At 3, 6, and 12 months after operation, the JohnerWruhs and AOFASAHS scores in the observation group were significantly higher than those in the control group(P<0.05). There was no significant difference in the complication rate between the observation and control group(P>0.05).Conclusion：Doublereverse traction reset and fixation with MiPPO for patients with comminuted fractures of middle and distal tibia can achieve satisfactory reduction, it is beneficial for fracture healing and rehabilitation of lower limb function.

Key words: tibia fracture, comminuted fractures, minimally invasive percutaneous plate osteosynthesis, doublereverse traction