The triple ankle fracture is the most serious type of ankle fracture, which should not be simply regarded as a double ankle plus one ankle fracture, but should be considered as a unified whole. Triple ankle fracture requires the anastomosis of the concave joint surface of the lower tibia and the saddle joint surface of the talus body, the maintenance of the normal curvature of the internal and external ankle, and the restoration of the normal anatomical relationship of the ankle joint, so as to restore the stability and function of the ankle joint as soon as possible after surgery. There is great disagreement in clinical practice regarding the surgical approach and the order of fixation for triple ankle fractures. Commonly used surgical approaches include postero-lateral approach, postero-medial approach and postero-lateral incision combined with postero-medial incision. The repositioning and internal fixation of posterior ankle fractures need to be accomplished with the help of an external or medial ankle incision. for Haraquchi type I rotated posterior external rotation fractures, the sequence of external ankle, posterior ankle, and medial ankle is preferred. For posterior ankle fractures of Haraquchi type II with posterior external rotation and posterior internal rotation, when the external ankle is fixed, the plate screw fixing the external ankle will instead affect the exposure of the posterior ankle, thus affecting the repositioning and fixation of the distal tibia, so it is more advantageous to choose the sequence of posterior ankle one internal ankle and external ankle.