Tarng YW, et al. - Given the identified importance of articular reduction and column fixation in updated three-column theory for complex tibilal plateau fracture and the encountered difficulty in managing complex tibial plateau fractures (TPFs) with posterolateral (PL) articular injury, researchers sought to describe a strategy of combined positions and approaches to treat these injuries as well as the associated outcomes. From 2014 Jan to 2016 Dec, treatment was provided to 132 patients of TPFs. The involvement of articular surface and associated columns was determined in the preoperative evaluation including plain films and 2D/3D CT scans. Patients with three column TPFs with PL corner injury were included in this work. Patients were put in prone position first with reverse L incision to manage PL articular impaction and posteromedial (PM) fractures and then were repositioned in supine to treat anterolateral fixation. They recorded postoperative radiographic analysis, physical examination findings, and patient-reported outcome scores from the Knee Injury and Osteoarthritis Outcome Score questionnaire. They reported the average time to union of 5.2 months (range 4-8months). The satisfactory articular reduction was noted in 13/16 (81%) of patients by plain films (less than 2 mm articular step off). All patients had healing without secondary displacement or infection. Satisfactory coronal (medial proximal tibia angle 84.68 degrees) and sagittal alignment (posterior proximal tibia angle 84.75 degrees) were noted in all patients. Outcomes thereby suggest this strategy as an effective method for treating three-column tibial plateau fractures with PL articular injury.