Fractures affecting the tibial plateau posterior aspect represent a difficult challenge in terms of treatment. Treating articular depression in tibial plateau fractures often involves elevating the fragment (s), residual defect filling utilizing bone grafts or substitutes, as well as providing support to the articular fracture reduction using screws via a plate positioned medially and/or laterally. Treatment of tibial plateau fracture may be non-operative or operative. Fracture proximal tibia can be surgically treated by various options including plate osteosynthesis, external fixator, (CRPF), (AAPPO) or primary total knee replacement. (ORIF) of tibial plateau fractures by plate as well as screws can be achieved by several types of plates and many approaches including plates [conventional non locked plates, locked plates, one third tubular plate], external spanning fixator and CRPF. There are some tibial plateau fractures complications including injury of vascular, nerve and ligaments, infection, nonunion, malunion, posttraumatic arthritis and stiffness.