Technical Guide: Transfibular Ankle Arthrodesis with Fibular-Onlay Strut Graft

A wide range of techniques have been described for ankle arthrodesis, and although all of these have been shown to provide stability, few have been shown to achieve a solid construct in patients at risk of nonunion. In this technical guide, we describe a modified transfibular approach to ankle arthrodesis that uses a fibular-onlay strut graft for use in patients at high risk for nonunion. In our experience, the technique has been effective and reliable.