Ankle fusion is indicated in the following:

• painful arthritis following

  • infection 

  • trauma (most common cause)  

  • chronic instability

  • Necrosis of the talus 

  • inflammatory arthropathy

  • primary osteoarthritis

• neuropathic arthropathy

• tumor resection

• salvage for failed ORIF 

• salvage for failed Total ankle replacement

• Optimal Position  

  • neutral dorsiflexion

  • 5-10° of external rotation

  • 5° of hindfoot valgus

  • 5 mm of posterior talar translation

• Arthroscopic arthrodesis

  • only indicated if minimal deformity present

• Open arthrodesis

  • transfibular approach often used when deformity present

    • screw fixation

    • plate and screw construct

    • external fixation

  • staged approach

    • infection should be cleared prior to placement of definitive internal hardware for arthrodesis