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This retrospective study aims to investigate the efficacy and safety of a combined posterior lateral and anteromedial approach in the treatment of terrible triad of the elbow (TTE).TTE patients who received a combination of posterior lateral and anteromedial approach or other conservative treatments were included in the present study. The postoperative functions of the elbow and the severity of traumatic arthritis were assessed using the Mayo Elbow Performance Score (MEPS) and visual analog scale (VAS). Extension–flexion of elbow joint and rotation of forearm were also measured.A combined posterior lateral and anteromedial approach or other conservative treatments showed significant improvements in the activity of the elbow, MEPS, VAS, the excellent rate, and x-ray results. The postoperative healing time and complication rate of patients who received a combined posterior lateral and anteromedial approach significantly decreased compared to those who received other conservative treatments.Patients with TTE who received a combined posterior lateral and anteromedial treatment had an increased fracture healing rate, showed improved recovery of elbow functions and had fewer complications.