Background: Tibial plateau fractures including the metaphyseal and epiphyseal regions constitute 1% of all fractures and 8% of fractures in the elderly. Surgical treatment of bicondylar plateau fractures include stabilization with an external ring fixator, and internal fixation with medial and lateral plates using two surgical approaches.

Methods: A prospective clinical trial, simple bicondylar tibial plateau fractures were functionally and radiologically evaluated in fourteen patients and treated in Orthopedic Department, Faculty of Medicine, Zagazig University and Ahmed Maher Teaching Hospital. The cases were managed by open reduction and fixation by unilateral locked plate. All patients are followed up clinically and with x-ray immediately, 1, 2, 3 and 6 months postoperatively.

Results: In this study Rasmussen anatomical score was 13.14±1.35 in first month, 13.71±1.32 in 3rd month and 14.3±1.4. Rasmussen anatomical functional was 22.92±3.07 in first month, 26.0±3.63 in 3rd month and 26.7±2.3 6 month with significant increase. 28.6% from studied group were complicated the highest one was infection 2 cases and Compartment syndrome, fixation failure, hardware irritation each of them 1 case only.

Conclusion: Bicondylar tibial plateua fractures occur due to high energy trauma, axial loading, Varus and valgus applied forces leading to articular depression and malalignment leading to increased risk of posttraumatic osteoarthritis. Single lateral locked plate can be an effective implant in providing fracture stabilization of bicondylar tibial plateau fractures. Using lateral locked plate is better in treatment of simple bicondylar tibial plateau fractures.