Tibial plateau fractures are one of the commonest intra-articular fractures resulting from indirect coronal or direct axial compressive forces. Fractures of tibial plateau constitute 1% of all fractures and 8% fractures in the elderly. Acute subdural hematoma (aSDH) is commonly encountered in the emergency department in patients with traumatic injuries. If the hematoma is small, non-expanding and asymptomatic, it is managed conservatively. However, other injuries sustained during trauma may warrant surgical intervention, during which anesthetic management becomes challenging. There have been reports of rebleeding in patients with aSDH after undergoing surgery under either general or spinal anesthesia. Here we present studies where tibial surgery for trimalleolar fracture was successfully performed.