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abstract Purpose: To describe an indirect reduction technique during minimally invasive percutaneous plate osteosynthesis (MIPPO) of tibial shaft fractures with the use of a distraction support. Methods: Between March 2011 and October 2014, 52 patients with a mean age of 48 years (16e72 years) sustaining tibial shaft fractures were included. All the patients underwent MIPPO for the fractures using a distraction support prior to insertion of the plate. Fracture angular deformity was assessed by goni-ometer measurement on preoperative and postoperative images. Results: Preoperative radiographs revealed a mean of 7.6?(1.2?e28?) angulation in coronal plane and a mean of 6.8?(0.5?e19?) angulation in sagittal plane. Postoperative anteroposterior and lateral radio-graphs showed a mean of 0.8?(0?e4.0?) and 0.6?(0?e3.6?) of varus/valgus and apex anterior/posterior angulation, respectively. No intraoperative or postoperative complications were noted. Conclusions: This study suggests that the distraction support during MIPPO of tibial shaft fractures is an effective and safe method with no associated complications.