This retrospective study evaluated the surgical management of 117 tibial plateau fractures treated between 1990 and 1998. At last patient follow-up, results were rated good to excellent in 94, fair in 13, and poor in 10 cases. Follow-up radiographs showed degenerative changes in the lateral compartment in 29 cases. Other complications included five wound infections, two deep venous thromboses, five delayed unions, and three nonunions. Operative treatment of tibial plateau fractures is recommended as it enables better alignment, meniscal access, and other soft-tissue injury repair.