Tarng YW, et al. - A strategy of combined positions and approaches to treat complex tibial plateau fractures (TPFs) with posterolateral (PL) articular injuries was presented. In addition, the surgical technique with its outcome was reported. Researchers identified 132 patients of TPFs who were treated in their institution from 2014 Jan to 2016 Dec. Three column TPFs with PL corner injury was the inclusion criteria. To manage PL articular impaction and posteromedial (PM) fractures, the patients were put in prone position first with reverse L incision. Then the patients were repositioned in supine to manage anterolateral fixation. The mean duration of time required for union was 5.2 months (range 4-8 months). Satisfactory articular reduction by plain films (less than 2 mm articular step off) was evident in 13/16 (81%) of patients. Healing without secondary displacement or infection was reported in all patients. Overall, outcomes support the efficacy of this strategy in treating three column tibial plateau fractures with PL articular injury.