There is a better surgical approach available: a new surgical approach for intercondylar fractures of the humerus via both sides of the triceps muscle. The medial-lateral muscle gap approach is chosen to cleverly avoid damage to the triceps muscle, protect the integrity of the elbow extension device, and allow the patient to perform early joint motion. This approach has neither the disadvantage of excessive muscle soft tissue injury caused by the traditional transglottic flap approach (Ding Weihua, Chinese Journal of Orthopaedics 2000, 20: 508-509), nor is it troubled by nonunion of the fracture, prolapse of the internal fixation and occurrence of osteoarthritis after transglottic osteotomy (Ackerman, 1988; Jupiter, 1985; Kuhn, 1995). Muller et al. (1979) showed that a mobile elbow joint allows the fixation plate to act like a tension band to promote healing of intercondylar fractures, whereas a stiff elbow joint can interfere with fracture healing. The unique design and simplicity of the approach via both sides of the triceps allows the operator to complete the management of complex fractures while leaving the elbow extension device intact without damaging the surrounding tissues. In conclusion, the repositioning and fixation of Riseborough II and III intercondylar humeral fractures can be performed entirely through the triceps approach on both sides, and there is no need to cut the triceps muscle or perform ulnar hawk osteotomy. The surgical steps are as follows: 1. Make a slight curved incision on the posterior side of the left elbow to avoid the ulnar hawk’s beak and cut the skin, the incision is about 10 cm long, separate the subcutaneous tissue, find the ulnar nerve in the ulnar nerve groove of the left medial humeral condyle, pull the film strip, and free the distal and proximal ends for a total of about 8 cm; 2. Separate the humerus from the medial and lateral triceps, and from the humeral radius and triceps gap to the distal humerus under the periosteum, and then pull the ulnar nerve from the medial side. The fracture end was visible when the ulnar nerve was detached from the medial side and the triceps muscle was dissected from the belly to the distal humerus and peeled under the periosteum. 3.After the fracture of the internal and external condyles of the humerus was repositioned satisfactorily, two 1.0 mm Kristen pins were inserted from inside to outside to temporarily fix the intercondylar fracture of the humerus, and a hollow tension screw was drilled from outside to inside, depending on the flatness of the joint surface, the fracture was fixed firmly; 4.The distal end and proximal end were repositioned, fracture fragments were placed, and two 1.5 mm Kristen pins were drilled from the internal and external condyles respectively to temporarily fix the fracture satisfactorily, and a long reconstruction plate was selected. Shape it to conform to the physiological curvature of the epicondyle, and then select a 1/3-arc titanium plate to conform to the physiological curvature of the medial condyle. Drilling and fixation were performed. The elbow joint was moved to check the flexion and extension function. The fracture was classified as type IV according to Riseborough’s classification. The clinical manifestations of the fracture were: severe deformity of the elbow joint, limitation of movement, significant pressure pain in the humeral condyle, palpable bone rubbing and abnormal activity. The fracture is characterized by widening of the humeral condyle due to intercondylar displacement and separation, shortening of the arm due to proximal displacement of the ulna, abnormal isosceles triangle of the elbow joint, and instability of the elbow joint in all directions. The posterior elbow incision is divided into straight, curved, and “S” shaped incisions. There is still a debate whether to cut the triceps tendon or to cut the ulnar hawk’s beak to enter the joint, because cutting the triceps tendon reveals the anterior and distal ends of the elbow joint poorly, and cutting the elbow extension device of the triceps muscle makes it worry about its rupture during the early active activities of the elbow joint after surgery, and it is also easy to cause tendon adhesions and weaken the elbow extension force later. It is proposed to use a triceps splitting approach, in which the triceps tendon membrane is incised medially, the tendonous part attached to the ulnar hawk is sharply peeled off, and the elbow joint is exposed by distraction to both sides. The advantage of trans-ulnar osteotomy is that the posterior aspect of the joint is directly exposed after the osteotomy and the distal end of the humerus is better exposed. In 1982, Bryan and Morrey proposed a posterior approach to the elbow to protect the triceps, with an incision starting 9 cm proximal to the tip of the ulnar hawk and ending 7 cm distal to it, making a straight posterior median incision to protect the ulnar nerve. The nerve is stripped from the humerus at the medial part of the triceps along with the periosteum of the rural part of the ulnar eminence, which is turned laterally, and the elbow muscle is turned under the periosteum from the proximal side of the ulna, and the whole elbow joint has been exposed, and the posterior joint capsule is often turned with the triceps mechanics, preserving the continuity of the triceps mechanics and easy to rectify, with fast recovery. The choice of internal fixation: including cancellous tension screws, tension band fixation, “Y” shaped plate fixation, medial and lateral double splints of different strengths. Currently, it is believed that double splints are the most stable fixation. The double splints are fixed perpendicular to each other to support the bone under tension and bending load and to prevent loss of repositioning and maintain the anatomical alignment of the fracture, especially in cases with comminuted fractures of the articular surface, where the bone defect involves the articular surface and intercondylar compression should be prohibited, as otherwise the intercondylar width will be narrowed. For these fractures, double splints can provide strong fixation of the parenchymal portion of the support.