Objective: Determine the changes in the structure of methods of internal osteosynthesis in treatment of patients with long-bone fractures in municipal multi-field emergency hospital of the modern Russian megalopolis. Carry out comparative analysis of effectiveness of use of minimally invasive osteosynthesis and conventional plating of long-bone fractures. Material and methods. We have studied the results of 1249 surgical operations of internal fixation of long-bone fractures performed in one of a municipal multi-field emergency hospitals of Saint Petersburg (Russia). We have studied the statistics of 1999-2000 and 2010. Results and conclusions. Minimally invasive osteosynthesis has occupied a leading position in the structure of internal fixation of long-bone fractures within the current 10 years period. Although such operations demand precise following surgical techniques, ability to use expensive implants and equipment as well as comparatively higher and longer training of orthopedic surgeons. These circumstances seriously limit effective use of minimally invasive osteosynthesis for the current moment. But at the same time conventional plating techniques haven’t lost their importance for treatment of patients with long-bone fractures. These techniques still occupy an important part among the methods of osteosynthesis used in the Russian multi-field hospitals. It reveals the need for continuous improvement of tactics used by orthopedic surgeons as well as the technique of performing such operations.