Introduction: Tibial plateau fractures (TPFs) are severe articular fractures of the proximal tibia that threaten knee stability and mobility. Their increasing incidence, associated with the rise in road traffic, and their functional impact justify rigorous management and particular attention to their medico-legal implications. Materials and Methods: This was a 12-month prospective descriptive study conducted from March 17, 2014, to March 16, 2015, including 18 cases of TPFs treated in the Department of Orthopaedics and Traumatology at Ignace Deen University Hospital, out of 4,215 hospital admissions. Epidemiological, clinical, therapeutic, and outcome data were collected. The Duparc and Ficat classification was used, and outcomes were assessed according to the Merle d’Aubigné and Mazas functional criteria. Results: The frequency of TPFs was 0.42% of hospital admissions. The mean age was 35.5 years (range: 11–60 years), with a male predominance (sex ratio = 5). Road traffic accidents accounted for 66.66% of cases. Unicondylar fractures were the most frequent, accounting for 72.22% of cases. Surgical treatment was performed in 72.22% of patients. Functional outcomes were very good in 66.67% of cases and good in 27.78%. Six postoperative complications were observed, representing 33.33% of surgically treated patients. The mean length of hospital stay was one to two weeks in 72.22% of cases. Conclusion: TPFs are serious articular injuries for which early surgical management can achieve good functional outcomes. When these fractures occur following road traffic accidents or occupational accidents, they require a structured medico-legal approach, including a comprehensive initial medical certificate, assessment of temporary total incapacity for work (TTIW) and permanent partial impairment (PPI), and thorough documentation of complications.