High-energy tibial plateau fractures are difficult to manage, as they are often associated with severe soft tissue injuries (open wounds, crushing, marked swelling, bruising, blebs formation and/or compartment syndrome). The management is controversial and the objective of stable, pain free knee joint with a functional range of motion (ROM) eluded most of the treatment modalities. The outcome is usually poor, with high rates of wound problems, infections, varus collapse, knee stiffness, and articular malreduction. Minimally invasive techniques by using periarticular cancellous screws along with JESS, allow the rigid fixation of small pieces of cancellous bone and intra-articular fractures, easy wound surveillance, early joint mobilization and weight bearing, and minimal soft tissue disruption. Through this book we are sharing our experience of managing tibial plateau fractures associated with severe soft tissue injuries. The outcome was excellent and was comparable to others methods of treatment. Thus, this book will be of immense help to the trauma surgeons in managing tibial plateau fractures associated with severe soft tissue injuries.