Ankle arthrodesis has long been the gold standard for end-stage arthritis following failure of non-operative management. For many years, arthrodesis was performed through an open, extensile incision. Although open techniques consistently yield acceptable fusion rates and time to fusion, the risk of skin complications is particularly high in at-risk patients. Recently, minimally invasive ankle risk of soft tissue healing problems, but also to achieve higher fusion rates and decreased time to fusion by reducing soft tissue stripping and preserving the blood supply to the arthrodesis site. Minimally invasive approaches include arthroscopic and mini-open techniques, both of which have demonstrated equivalent, if not better, outcomes when compared to open arthrodesis. These approaches provide an excellent option for patients who are particularly at risk for skin and other soft tissue complications.
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