Objectives: To compare the clinical and radiological outcomes of distal tibial Metaphyseal fractures fixed with distal tibial locking plates with or without lateral malleolus fixation. Methods: Among 40 patients fixed with distal tibia locking plate from 2016 to 2021, 22 cases were fixed with lateral malloelus and 18 cases without fixing the lateral malleolus. The AOFAS was analysed to know about the clinical outcome and Lateral distal tibial plafond angle(LDTA) was measured after 6 months after fixation and compared. Results: The American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-hind foot score average was slightly reduced in lateral malleolus not fixed group, but significant reduction was noticed in lateral malleolus not fixed group. Key Words: Tibial lower Metaphyseal fracture, AOFAS score, Lateral distal tibial plafond angle, MIPO