The materials for the study are represented with the data of examination and treatment of 314 patients (180 - the basic, 120 - the control group after surgical treatment, 14 patients underwent conservative treatment) with fractures of the proximal tibia epimetaphysis. Fractures of the proximal tibia epimetaphysis were most common for people of working age from 21 to 60 years. Fractures of this type were prevalent in men aged from 21 to 50 years, and in female patients after 60 years. In significant number of patients ( 104 (33.1 %)) fractures were caused by falling down from the stairs or falling on a flat surface, among them there were predominantly women over 62 (71.3 %), whose average age was 56 years old, but a significant proportion of the patients (41.1 %) were damaged in an accident, which indicates high rate of mechanical factors causing these fractures. Isolated fractures of internal condyle were observed in 42 (13.4 %) patients, external - in 179 (57.0 %) cases, fractures of both condyles were observed in 93 (29.6 %) patients. The most frequent cases among the fractures of epimetaphysis proximal tibia fractures were type BII (24.2 %) of CII-III (37.5 %) according to AO / ASIF classification, indicating a significantly large part of the highly energetic fractures. Conducted biomechanical study allowed to clarify the mechanical characteristics of the proximal tibia epimetaphysis and optimize specifications of fixing structures, which allowed us to propose the designed construction of external fixation mechanism and anti-compression screws. On the basis of clinical and instrumental studies a classification of intraarticular fractures of the proximal tibia epimetaphysis was developed, arthroscopically controlled osteosynthesis (term referring to the use of arthroscopic techniques and the application of various methods of fixation, depending on the type of fracture), a system of rehabilitation was developed. The most severe injuries are fractures of types BII-III, CII-III, which are high-energy injuries. In case of such a damage the absolute indication for surgical treatment is the use of the developed arthroscopically - controlled osteosynthesis and combined osteosynthesis, with the aim to restore the congruence of the articular surface and fixation of bone fragments, which constitute it, by means of minimally invasive structures (predominantly screws). Additional stabilization is carried out by means of external fixation. On the basis of the individual approach in the treatment of patients of this category, which is based on certain indications in selecting the method of fixation in each type of fracture, preoperative planning, implementation of arthroscopically - controlled and combined methods of surgical treatment of patients with fractures of the proximal tibia epimetaphysis allowed to obtain the following results of treating the patients with the fractures of type BI: excellent result in 51.3 % of patients, good - in 43.6 %, satisfactory - in 5.1 %; type BII - at 54.5 %, 38.2 %, 7.3 %; type BIII - 46.9 %, 40.6 %, 12.5 %; type CI - 50.0 %, 38.9 %, 11.1 %; type CII - 51.8 %, 33.9 %, 14.3 %; in the treating the fractures of type CIII excellent results were obtained in 46.8 % of patients, good - in 32.3 %, satisfactory - in 16.1 %; unsatisfactory - in 4.8 %. Unsatisfactory results of treating the patients with fractures of type CIII are stipulated for the severity of damage to the bone, cartilage and soft tissue of the structures of the knee.
