Complex triple ankle fractures (medial, lateral, and posterior ankle) often have incisional problems during surgical treatment. Because of the thin local soft tissues of the ankle joint, poor soft tissue healing, infection, and exposure of internal fixation are likely to occur. The postero-lateral approach can simultaneously take into account the repositioning and fixation of both the lateral and posterior ankle, reducing the incision while also selecting the postero-lateral gap where the soft tissues are more abundant, reducing the incisional complications. The intraoperative operation is also simplified, and the repositioning and fixation of the three ankles can be solved in the prone position without frequent changes in position. Moreover, the plates were all supplemented in the direction of preventing the fracture block from displacement, i.e., the anti-slip side, which effectively reduced the failure rate of internal fixation. The postoperative scar healing was good and the ankle function recovery was satisfactory