Abstract: Objective To explore the surgical approaches and the main operative points of surgical treatment of the terrible triad elbow. Methods 15 cases were treated with operation. 12 cases were operated with lateral approach combined with anterior median mini incision. 3 cases were operated with lateral approach combined with inner approach .The mini screws and mini plates were used to fix radial head fractures, and external ifxture or external plaster ifxation were used in the treatment. Results The results indicated that the excellent and improved rates were up to 80%. Four cases were improved greatly, 8 cases improved obviously, 2 cases improved, 1 case improved poorly with Mayo elbow score standard. Conclusion The joint capsule of front in elbow, the coronoid process of the ulna and the radial head are very important on the stability of elbow joint. The external ifxture is superior to plaster ifxation in clinical practices.

Key words: posterior dislocation of the elbow, fracture of the ulna coronoid, radial head fractures, mini screws and mini plates