The classification of tibial plateau fractures is based on morphologic
al criteria according to AO/ASIF [18] and Schatzker [21] or on functio
nal criteria according to Moore [15]. A total of 81 acute tibial plate
au fractures were operated on over a 6-year period. The patient data a
nd the operative procedure are given (not including late results). Som
e 6% of ligamentous lesions were treated conservatively. Bicondylar os
teosynthesis was performed in 11 %, and 14 % of the operations were mi
nimally invasive procedures. In 61.7 % the plateau was fixed by a butt
ress plate. Autologous cancellous bone from the iliac crest was implan
ted into the fracture, especially into depressed wedge fractures (Type
AO/ASIF B3 or Moore Type IV). In 39.5 % of the cases a corticocancell
ous wedge-shaped bone chip from the iliac crest was used. Compications
were rare, and no infection was observed. Most important are the soft
tissue balance, the timing of surgery, choice of longitudinal incisio
ns directly above the lesion, and a stabilization procedure which main
tains blood flow and coverage of the fracture. The operative procedure
s are described including tibial plateau fractures in children and the
management of complications. In speical situations a conservative tre
atment is still useful.