Abstract：[Objective] To evaluate the clinical efficacy of new approach （fibrobone longitudinal osteotomy approach） for treatment of posterolateral tibial plateau fractures. [Methods] A retrospective analysis of 21 patients with posterolateral tibial plateau fractures from January 2012 to December 2017 who was performed operation in our hospital. There were 14 males and 7 females with an average age of 47.5 years (range,25-72 years). Causes of injury: 18 cases of traffic injuries and 3 cases of falls from height. The patients underwent posterior lateral approach and the fibular head was longitudinally osteotomized. The collapse height of the platform, operation time, rehabilitation time, width of fibrobone osteotomy, fracture healing time and weight-bearing time, and knee function score were recorded. [Results] CT measurements showed that the posterolateral platform collapsed an average of 5.5±2.4 mm, all patients involved the posterior lateral angle, and the average operation time was 65±18 min，width of fibula head osteotomy 5～10mm. Knee joint flexion and extension exercise was started 2 days after operation. The knee joint activity was extension15±7degrees and flexion 100±15 degrees 2 weeks after operation.All the patients were followed up for about 12 to 18 months, with an average of 15 months. All the fractures healed. The X-ray showed an average healing time of 12±3.6weeks and a complete weight-bearing time of 16±4.8 weeks. One patient with complications of common peroneal nerve injury and recovered 4 months after surgery. One patient with superficial incision infection and was cured after 3 weeks of dressing change. At the last following-up, none of the patients in this group had varus, valgus knee deformity, and fracture relocation. 18 months postoperatively, the Rasmussen radiological score was 17.5±1.6, the knee flexion was 122.5±18°, and the knee HSS score was 85±9.6 (72-98). [Conclusions] The posterior lateral fibula head osteotomy for the treatment of posterolateral tibial plateau fractures with sufficient visual field is beneficial to the reduction and internal fixation.of fractures and which is one of the ideal surgical approaches for posterolateral plateau fractures.