Abstract:[Objective] To introduce the surgical technique and preliminary clinical results of minimally invasive internal fixation at the second stage for open Schatzker type VI tibial plateau fractures. [Methods] A total of 16 patients were treated by debridement and vacu- um sealing drainage (VSD) in the first stage, and minimally invasive plate fixation in the second stage for open Schatzker VI tibial plateau fractures. In the second-stage operation, minimal invasive plate osteosynthesis (MIPPO) under antagonistic traction were conducted. As two Steinman pins were inserted parallelly at the femoral supracondyle and distal tibia respectively, antagonistic traction force was applied grad- ually to restore the alignment and reduction of the fractures, and then percutaneous fixation of the fractures with a proximal tibial anatomi- cal locking plate was completed by the MIPPO technique. [Results] All the 16 patients had the two-stage surgical procedures performed successfully without serious complications. The clinical fracture union was achieved in 4~8 months, with (6.14±1.35) months on an average, and HSS function score ranged from 86 to 92, with an average of (89.44±2.43) at the latest follow-up. Radiographically, all the patients got satisfactory fracture reduction with smooth articular surface, while the Rasmussen scores of tibial plateau anatomy ranged from 12 to 18, with an average of (14.12±1.60) . [Conclusion] This technique does achieve good reduction and reliable fixation of the fractures with great- ly reducing iatrogenic trauma, which is beneficial to fracture healing, and avoid further necrosis of the severely injured skin and soft tissue of the open Schatzker type VI tibial plateau fractures.