INTRODUCTION: The purpose of this study was to analyze the results, prognosis and complications in the treatment of proximal tibia plateau fractures, and to suggest the guideline for the proper management in the difficult cases of tibial plateau fractures. MATERIALS AND METHODS: We have analyzed 27 cases, which surgically treated during recent five years with average 36.6 months follow-up. Patients ranged in age from 24 to 83 years at the time of hospitalization, consisting of 19 males(70.4%) and 8 females(29.6%). The type of fracture by Schatzker classification revealed in type I 3 cases(11.1%), type II 1 case(3.7%), type III 0 case(0%), type IV 3 cases(11.1%), type V 1 case(3.7%) and type VI 19 cases(70.4%). The associated injury occurred in 22 cases(81.5%), most of them were ipsilateral fibular, ipsilateral femoral and radioulnar fractures. The results were evaluated by Blokker 's criteria. RESULTS: Screw fixation was done in 4 cases(18%) and plate fixation in 23 cases(85.2%), and bone grafting was done in 10 cases(37.0%). There were 10 postoperative complications with 3 cases of knee ankyosis, 3 cases of angular deformity, 3 cases of infection, and 1 case of traumatic arthritis. According to Blokker 's criteria, 22 cases(81.5%) had satisfactory results. CONCLUSIONS: Accurate anatomical reduction and rigid internal fixation of the proximal tibial plateau fracture enabled early motion and normalization of injured soft tissues, and also provided functional improvement of the knee.