This is a retrospective review of 18 patients with tibial plateau fractures Schatzker type VI. These cases were performed in our medical centre from January 2003 to December 2004. The Ilizarov technique (Russian technique) using the ring external fixator was the technique performed. Articular reconstruction and joint alignment were achieved with traction and olive wires with washers. One case required percutaneous elevation of the articular surface and bone grafting through a cortical window. Average clinical union was achieved within 4 months of trauma. Mean final knee flexion was 85°, which is compatible with walking. All patients successfully returned to their previous occupations. In conclusion, the Ilizarov technique has been shown to be a good option and a viable tool in the management of these complex and unstable injuries.