Terrible triad injuries of the elbow are characterized by an elbow dislocation, a radial head or neck fracture, and a coronoid fracture. Disruption of the lateral ulnar collateral ligament (LUCL) is commonly observed in patients with this injury pattern. Failure to repair the LUCL leads to posterolateral rotatory instability. In general, terrible triad injuries of the elbow are observed in men in their thirties and forties after a fall onto an outstretched hand. For diagnostic purposes, plain radiographs are obtained. Closed reduction is attempted in the emergency department. CT scans often are indicated to better visualize the fracture pattern. Most terrible triad injuries are managed surgically given the inherent instability of the elbow with LUCL disruption. This video describes a unique technique that involves the use of a cortical button for the management of an LUCL injury in a patient with a terrible triad injury. A Kocher approach allows for visualization of the anatomic footprint of the LUCL on the lateral condyle of the humerus. The LUCL is reattached to its insertion point on the lateral epicondyle with the use of a cortical button. The video reviews patient presentation, physical examination, imaging studies, technical pearls of the procedure, and the postoperative rehabilitation protocol.