82 patients with 83 displaced bicondylar tibial plateau fractures were randomized to receive standard open reduction and internal fixation with medial and lateral plates or percutaneous and/or limited open fixation and application of a circular fixator. At the 2 year follow-up there was no significant difference in clinical outcomes between the open reduction group and circular fixator group, however, a marginally faster return to function was observed at 6 months in the circular fixator group. Additionally, patients in the circular fixator group required a significantly shorter hospital stay than the patients in the internal fixation group, and the open reduction and internal fixation group exhibited significantly more complications.