Objective To investigate the effect of proximal fibula osteotomy for the treatment of posteriolateral tibial plateau fractures. Methods Sixty cases of posteriolateral tibial plateau fractures in our center from September 2010 to September 2012 were selected as the study subjects. The surgical mode adopted the proximal fibular osteotomy from posteriolateral approach of knee joint. In the approach,the proximal fibula and common peroneal nerve were exposed from the knee joint posteriolateral side;the proximal fibula was turned up after osteotomy ,and posteriolateral tibial plateau was revealed from the popliteal muscle and soleus muscle gap. The fracture was reset under direct vision and fixed with oblique T-shaped locking plate or limited contact compression plate in the posterior lateral side. Results All 60 cases were followed up for more than 12 months. Compared with postoperative 1 month,the maximal flexion degrees of knee joint at postoperative 3,6,12 months had statistically significant dif-ference(t=5.792,8.288,8.776,P<0.01);but the maximal flexion degrees of knee joint had no statistical difference between post-operative 6 months and postoperative 12 months(t=1.562,P>0.05). The knee HSS scores at 3,6,12 months had statistical differ-ences compared with those at postoperative 1 month (t=8.139,9.900,8.901,P<0.01). The knee HSS scores had no statistically sig-nificant differences between postoperative 3 and 6 months with postoperative 6 and 12 months (t=1.991,2.202,P>0.05). No cases of postoperative necrosis of operation area skin ,infection or loosening of internal fixation occurred. Conclusion Proximal fibular osteotomy by posteriolateral approach for the treatment of posteriolateral tibial plateau fractures can conduct the reduction of articu lar surface and fixation under direct vision,prevents the fracture re-displacement and is conducive to the recovery of knee joint function.%目的：探讨腓骨近端截骨治疗胫骨后外侧平台骨折的手术效果。方法选择2010年9月至2012年9月该中心收治的胫骨后外侧平台骨折患者60例作为研究对象，手术方式采用膝关节后外侧入路腓骨近端截骨治疗。入路自膝关节后外侧显露腓骨近端及腓总神经，腓骨近端截骨后向上翻起，于腘肌和比目鱼肌间隙分别显露胫骨后外侧平台，骨折块在直视下复位，用斜T型锁定钢板或有限接触加压钢板于胫骨后外侧固定骨块。结果60例患者全部获得12个月以上的随访。患者第3、6、12个月膝关节最大弯曲度与术后1个月比较，差异均有统计学意义（t=5.792、8.288、8.776，P<0.01）；但第6个月与第12个月膝关节最大弯曲度比较，差异无统计学意义（t=1.562，P>0.05）。第3、6、12个月膝关节医院特殊手术评分（HSS评分）与术后1个月比较，差异均有统计学意义（t=8.139、9.900、8.901，P<0.01）；第3、6个月与第6、12个月HSS评分比较，差异均无统计学意义（t=1.991、2.202，P>0.05）。术后无一例患者发生手术区皮肤坏死、感染或内固定松动。结论经HSS评分后外侧腓骨近端截骨治疗胫骨平台后外侧骨折，可直视下复位关节面和固定，并防止骨折再移位，有利于患者良好的膝关节功能恢复。
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