A 59-year-old female presented with a bicondylar tibial plateau fracture. Past medical history was significant for smoking and osteoporosis. CT scan revealed a Shatzker IV fracture with medial column disruption. The fracture necessitated fixation in both the medial and lateral columns to prevent varus collapse and potential lateral implant failure. The patient was treated operatively through a lateral approach with fixation in both the medial and lateral columns. Medial column support was achieved through insertion of IlluminOss through a lateral incision, eliminating the need for soft tissue compromise on the medial side. The flexible balloon catheter was inserted, filled with liquid monomer, and cured using visible light. Attention was then turned to the lateral joint space. Bone graft was placed in the metaphysis to support reduction and a plate and screw construct was utilized for lateral fixation. Proximal screws were extended through the hardened IlluminOss implant for support. At 3-months postop, reduction was maintained, and no varus collapse was noted.