Background The posterolateral approach without a fibular osteotomy allows direct access to the posterolateral plateau and avoids complications associated with a fibular head osteotomy. The video presents the case of a 49-year-old male pedestrian struck by a car while cycling. Axial cuts of his CT scan demonstrate a displaced lateral plateau fragment and a large coronal plane fracture of the posterolateral plateau involving approximately one-third of the AP dimension of the articular surface. Method Surgical steps include a stepwise approach for posterolateral exposure followed by anterolateral exposure and then fracture reduction and sequential fixation starting from the back and moving toward the front. Results At 3 months after surgery, the patient had full and painless knee range of motion and a stable knee according to examination findings. Radiographs demonstrated a healed lateral tibial plateau fracture without loss of reduction. Overall alignment of the knee was maintained. There was no hardware complication. Conclusion The combined anterolateral and posterolateral approach to the proximal tibia without fibular osteotomy is a viable technique to achieve biomechanically sound fixation for lateral tibial plateau fractures that involve both the anterolateral and posterolateral aspects of the tibial plateau.