<prompt> The immediate treatment of unstable tibial plateau fracture is:Internal fixation with plate screwInternal fixation with nailExternal fixatorComplete bed rest  <response>: Internal fixation with plate screw 720-ApIeys 8th Unstable fracture of Tibial plateau - In younger patient, and more so those with a central depression of more than 5 mm, open reduction with elevation of the plateau and internal fixation with a buttress plate is preferred. Stable fracture - depression is slight less than 5 mm, if the patient is old and frail or osteoporotic the fracture is treated with closed reduction Skeletal traction for 3-4 weeks and then hinged cast brace for another 6 weeks. 