PURPOSE: We retrospectively reviewed the outcomes and efficacy of the percutaneous plate osteosynthesis for the distal tibia metaphyseal fracture. MATERIALS AND METHODS: Twenty-one patients suffering from fractures of the distal tibial metaphysis, with or without minimally displaced extension into the ankle joint, were treated by percutaneous plate osteosynthesis with narrow LC-DCP. According to the AO/OTA classification, 17 fractures had no articular involvement (A1=8, A2=6, A3=3) while 4 included intraarticlar extension (C1=4). RESULTS: At the final follow-ups(mean=20months), all the fractures healed without second procedures and the mean union time was 15.2 weeks. Only one patient had a malunion of rotational deformity due to inadequate prebending of plate, but there were no angular deformities over 5 degrees nor any shortenings of more than 1cm. There were no deep infections, nor any soft tissue compromise. Three patients had a partial limitation of ankle motion, but all the patients had excellent or satisfactory ankle function with mean OMA score of 89.1%. CONCLUSION: Percutaneous plate osteosynthesis is a safe and worthwhile method of managing distal tibia metaphyseal fracture while avoiding some of the complications associated with conventional open plating methods.