Objective:To study the effects of Taohong Siwu Decoction on bone metabolism in patients with fracture of tibial plateau after fixation operation. Methods76 patients with fracture of tibial plateau were randomly divided into the control group and treatment group,38 cases in each group. All the patients were treated with internal and external double plate fixation. Meanwhile,the patients in the treatment group were treated with Taohong Siwu Decoction in addition,with a course of 28 days. The clinical efficacy was observed in both groups,and the changes of bone metabolism indexes were compared before and after treatment.  Results:The clinical total effective rate was 97.37% in the treatment group and 81.59% in the control group. The clinical efficacy of the treatment group was better than that of the control group(P<0.05).Compare with treatment before,the serum levels of bone formation indexes including alkaline phosphatase (ALP),insulin-like growth factor I (IGF-I) and procollagen type I N-terminal propeptide (PINP) and the serum levels of bone metabolism indexes including matrix metalloproteinase-1 (MMP-1),matrix metalloproteinase-2 (MMP-2) and collagen type I cross-linked C-terminal peptide (sCTx) were increased in both groups after treatment (P<0.05),and the levels in the treatment group were all higher than those in the control group(P<0.05).  Conclusion:Taohong Siwu Decoction can significantly improve the knee joint function and bone metabolism in patients with fracture of tibial plateau after fixation operation,which promote the fracture healing.