Lateral tibial plateau fractures are particular fractures that can have a severe prognosis involving a joint biomechanically and functionally very important. Osteosynthesis is very often required as the articular surface must be accurately restored . Considering all fractures classified as B3 according AO, we considered 10 cases treated with Barr screw and 8 cases treated with K-wires positioned as a shelf after reduction a bone grafting. At the follow-up at 24 months, both the groups showed very good and comparable clinical, radiographical and functional results