This study aimed to evaluate the outcomes of treating postero-medial proximal tibia fractures using postero-medial plating in combination with medial or lateral column fixation. Thirty patients with postero-medial fractures were included, and their fractures were managed with direct surgical approaches to achieve anatomical reduction and absolute stability. After 12 months of follow-up, functional and radiological outcomes were assessed. The study found that 66.6% of cases had a postero-medial fragment with additional condyle fractures, while 33.3% had an isolated postero-medial fragment. Anatomical intra-articular reduction was achieved in 26.6% of cases, and the majority (63.33%) of patients had a functional outcome score of 25-26 based on the Rasmussen score. Overall, fixation of posteromedial coronal shear fractures using this approach resulted in better functional outcomes, quicker patient recovery, and a low incidence of complications, including loss of reduction and non-union. The findings support the use of postero-medial plating for managing postero-medial proximal tibia fractures, providing valuable insights for clinical practice.