Fractures that involve the distal tibial articular surface are difficult to manage because of the complexity of the articular injury, the associated proximal osseous extensions, and the associated soft tissue injury. Staged protocols have decreased the complications associated with the short-term management of these injuries. Alternative surgical approaches allow for improved articular visualization in a safe manner. Improved techniques of plate application allow for fixation of the articular segment to the tibial diaphysis without an extensive surgical exposure. The anterolateral approach allows for exposure, reduction, and fixation of most partial and complete articular injuries of the distal tibia. In addition, because of the location of the anterolateral approach, soft tissue wound complications and communication of the surgical incision with associated open traumatic medial wounds may be avoided. The reduction and fixation techniques allow for an accurate articular reconstruction and restoration of the joint position.