| ObjectiveTo investigate the clinical result of posterior medial approach for treatment of tibial plateau posterior column fracture.MethodsFrom 2013 to 2016，21 cases with tibial plateau fracture were enrolled in the study, including Schatzker classification Type Ⅰ 4 cases, type Ⅱ 5 cases，Type Ⅲ 8 cases, type Ⅳ 1 case, type Ⅴ 2 cases, and type Ⅵ 1 case. All cases were posterior column fracture according to “three-column” classification systems and treated through posterior medial approach. The therapeutic effect was evaluated by the knee functional therapy assessment method of HSS.ResultsAll patients were followed up for（11.23±3.14） months. According to HSS grading standards, 17 patients got excellent result，3 good，and 1 bad. After surgery, the good and excellent results were 95.2%.ConclusionsPosterior medial approach for the treatment of tibial plateau posterior column fractures, which can maximize the recovery of lower limb function, is an effective treatment.