A 62-year-old female presented with a classic bicondylar tibial plateau fracture with posteromedial comminution. The patient had poor body habitus and poor bone quality. The patient was initially treated with external fixation prior to definitive fixation. With the external fixator in place, anatomic alignment of the medial column was achieved percutaneously using a reduction clamp. The clamp was left in place while IlluminOss was inserted through a lateral incision,delivered via the intramedullary medial column, filled with liquid monomer, and cured using visible light. Attention was then focused laterally with fixation achieved using a plate and screw construct. Screws were placed throughout the IlluminOss implant to enhance the medial column support. Fixation of both columns was achieved percutaneously, with no medial incision required. Soft tissue disruption was minimal in this patient with a high potential for wound healing complications.