From June to July, I consulted 9 cases of tibial plateau fractures at outside hospitals, and all of them were complex plateau fractures, many of which were postero-lateral plateau fractures. It is difficult to achieve fracture repositioning and fixation according to the traditional incisions and methods, which require access from the posterior medial or postero-lateral incisions to better expose the fracture end and reposition and fix the fracture under direct vision. The general textbooks and specialized books only introduce the posterior medial and anterolateral incisions, which in my opinion cannot complete the effective repositioning and fixation of all tibial plateau fractures, and clinicians need to master the other 2 types of incisions, namely the posterior medial gastrocnemius head approach and the lateral fibular head osteotomy approach, which in fact are not difficult after proficiency in both approaches. The lateral peroneal head osteotomy approach can expose the posterior lateral and lateral tibial plateau, the author has completed more than 20 cases since 2011, and now feels very skilled, no common peroneal nerve injury occurred. During the consultation in several hospitals such as Zhongxiang, Luotian, Huangshi and Xiaogan, several directors were very happy that they could solve some special cases. In the author’s opinion, it is best for the physician to master the above 4 types of incisions in order to reach the point where he/she is comfortable with the treatment of all tibial plateau fractures.